Human breast milk is a complex biological matrix that plays a central role in infant nutrition and development. It may also serve as a route of exposure to pharmaceutical residues following maternal drug use. Quantitative data on the transfer of non-steroidal anti-inflammatory drugs (NSAIDs) into breast milk are essential to support their safe use during lactation, however, available analytical methods remain limited. This study reports the development and validation of a rapid and sensitive hydrophilic interaction liquid chromatography-electrospray ionization mass spectrometry (HILIC-ESI/MS) method for the simultaneous quantitation of tenoxicam, meloxicam, piroxicam, and the metabolite 5'-hydroxypiroxicam in human breast milk. Sample preparation involves simple protein precipitation procedure using only 25μL of human breast milk. Chromatographic separation is achieved within 8min. The method was validated over the range of 20 to 2000ngmL-1, with a limit of quantitation of 20ngmL-1 and correlation coefficients greater than 0.998. This is the first HILIC-ESI/MS method for the simultaneous quantitation of the targeted analytes in human breast milk. The validated HILIC-ESI/MS method was subsequently applied to screen breast milk samples collected from ten lactating women donating to a hospital milk bank. Although oxicam NSAIDs were not detected in this cohort, the method is well-suited for targeted screening of human milk in clinical or surveillance settings, including milk banks and pharmacovigilance studies.

Human milk composition varies in time to meet the evolving growth and developmental requirements of infants. While 24-hour (diurnal) variations in human milk composition for term-born infants have been reported, evidence concerning diurnal variation of preterm human milk composition remains inconclusive. To examine the presence of diurnal variations in macronutrient content in very preterm human milk. Milk samples were donated by mothers of very preterm infants (<30weeks gestation). Milk series (defined as sequential milk samples collected from one mother) consisted of 13 to 17 (median 15) samples, collected over three consecutive days. Milk macronutrient (fat, true protein and carbohydrates) content were measured using mid-infrared spectrophotometry (Miris HMA™). Rhythmicity analyses and logistic regression analyses were performed to explore associations between macronutrient rhythmicity and pregnancy duration (weeks), infants' sex, and lactational stage). Of the 22 milk series studied, 12 (55%) showed 24-hour rhythmicity in one or more macronutrients. Fat content showed rhythmicity in 41% of the series, with varying peak times. For carbohydrates, protein and calculated energy content, rhythmicity was only identified in 18%, 14% and 27% of the milk series, respectively. Longer pregnancy duration was associated with increased odds of rhythmicity (odds ratio 2.1 (95% confidence interval 1.02-4.21), p=0.04), but not with sex or stage of lactation. Over half of the preterm human milk samples exhibited diurnal macronutrient rhythmicity, mainly in fat levels. The observed rhythms had varying peak times, suggesting phase differences of the maternal rhythms.

FRET/SAXS integration reveals the digestion-absorption trade-off driven by dynamic self-assembly of human milk triacylglycerols.

New HPLC method for the separation and quantitation of individual milk proteins in human breast milk and bovine milk

TRPM2 mediates tire-derived pollutant 6PPD-Q-induced male reproductive impairment via autophagy in mice.

Colostrum-specific amino acids and lipids elevating lutein bioaccessibility at the micellization stage relative to mature milk and infant formula.

Organophosphate esters and their metabolites in paired maternal serum and human milk: Occurrence, transfer efficiency, and metabolic conversion.

This study evaluates whether liquid formula supplementation for preterm infants was non-inferior to breast milk fortifiers regarding growth and adherence to exclusive breastfeeding in an outpatient Kangaroo Mother Care Program from Colombia. An open-label randomised trial was initiated in 2016 and interrupted in 2018 because of the lack of fortifiers in the country and included 81 preterm infants born between 32 + 0 and 36 + 6 weeks/days of gestational age. Infants were assigned to receive either breast milk fortifiers or liquid formula, with outcomes assessed up to 40 weeks. No significant differences in anthropometric measurements were observed between the groups. More than two-thirds (69%) achieved exclusive breastfeeding, with higher rates in the fortifier group (73.0% vs. 53.0%, p = 0.06). This tendency persisted up to 6 months of corrected age. Breastfeeding was discontinued more frequently in the liquid formula group despite showing better gastrointestinal tolerance, ease of administration, and lower cost and contamination for home use. Liquid formula supplementation showed growth outcomes comparable to those of breast milk fortifiers at 40 weeks. Further research with larger samples is recommended to validate outcomes.

LDOB: multi-dimensional programmable lactose-derived oligosaccharide biosensors.

Metabolic engineering of Escherichia coli for uridine-5'-diphosphate N-acetylglucosamine production through salvage pathway.

Commercialising human milk-based products (HMBPs) poses complex public health, ethical, and regulatory challenges for governments around the world. This study investigates the corporate strategies of the HMBP industry through a qualitative analysis of industry documents obtained from the University of California, San Francisco's Industry Documents Library. The analysis identifies how HMBP companies construct markets by positioning their products as essential to neonatal care and leveraging scientific narratives and professional networks to expand market dominance. These practices include embedding corporate interests in public health messaging and knowingly competing with non-profit milk donation systems. The findings reveal tensions between profit-driven innovation and equitable access to healthcare. The study highlights parallels with other health-related industries, where intellectual property (IP) and market control can deepen inequity. To address these issues, the study emphasises the need for stronger regulatory oversight, enhanced transparency in corporate practices, and support for public milk banking systems. By situating HMBPs within the Commercial Determinants of Health framework, this research provides policymakers and public health advocates with critical insights to safeguard equity in maternal-infant healthcare.

Per- and Polyfluoroalkyl substances (PFAS) are persistent environmental contaminants widely used in consumer and industrial applications including stain- and water-repellent textiles, nonstick cookware, firefighting foams, and food packaging. Their persistence and bioaccumulation potential raise concerns about early-life exposure through breastfeeding. Despite increasing international attention, no biomonitoring data on PFAS in breast milk have been reported from Saudi Arabia. The study aim to quantify perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) in breast milk from lactating women in Riyadh and estimate infant exposure via breastfeeding using standardized exposure assessment methods. Breast milk samples were collected from 25 mothers within 30 days postpartum. Samples were analyzed by LC-MS/MS following solid-phase extraction. Estimated daily intake (EDI) for PFOA and PFOS was calculated using the equation EDI = (CBM × VBM) / BW, assuming an average infant body weight of 2.5kg and daily milk intake of 292.5 mL during early infancy. Quantifiable concentrations (> LLOQ = 25 ng/L) were detected in 4 of 25 participants. PFOA concentrations ranged from < LLOQ to 73.3 ng/L, and PFOS concentrations ranged from < LLOQ to 85.2 ng/L. Median concentrations for both compounds remained < LLOQ. Infant EDI values were below the U.S. EPA oral reference dose (20 ng/kg-bw/day) but exceeded EFSA benchmark values in 12% of samples for PFOA (EFSA = 0.857 ng/kg-bw/day) and 16% of samples for PFOS (EFSA = 1.857 ng/kg-bw/day). This study provides the first biomonitoring evidence of PFAS in breast milk in Saudi Arabia, demonstrating low but measurable exposure among lactating women. The findings underscore a need for expanded biomonitoring and assessment of potential exposure sources in the region.

As neonatal care continues to evolve, there is growing recognition of the need for individualized, functionally targeted nutrition in very preterm infants (VPIs). While human milk remains the gold standard, it frequently fails to meet the metabolic requirements of this high-risk group, requiring the adoption of fortification strategies. In this context, the study by Rasmussen et al., published in Pediatric Research, offers important insights into the metabolic implications of fortifying human milk with bovine colostrum (BC). The observed elevations in plasma concentrations of amino acids such as arginine, glutamine, and tyrosine suggest that BC may serve as a fortifier with potential clinical value. However, the disconnection between enhanced biochemical profiles and clear clinical benefit persists. Nutrient utilization depends not only on intake but also on inflammation, illness, organ immaturity, and individual metabolic variations. Infants' anthropometrics, mainly head circumference and length, remain essential reference values, mirroring brain and lean mass development. A shift toward precision strategies incorporating biomarkers and long-term developmental follow-up is needed. This approach might hopefully be translated into sustained clinical benefit for VPIs. IMPACT: This commentary emphasizes the importance of evaluating neonatal nutrition through both surrogate biomarkers and functional clinical outcomes to better capture physiological relevance. It highlights the limitations of relying exclusively on compositional or biochemical analyses when assessing nutritional adequacy in preterm infants. The article contextualizes the findings of Rasmussen et al. within the metabolic complexity characteristic of preterm physiology. It underscores the role of clinical heterogeneity and variable nutrient utilization in shaping metabolic responses. The commentary advocates for integrated, technology-supported strategies to enable individualized, real-time precision nutrition in neonatal care.

Midwifery Antenatal Postnatal Service (MAPS): A retrospective cohort study exploring perinatal outcomes and consumer satisfaction.

This study is part of an ongoing assessment of organochlorine pesticide (OCP) levels in the breast milk of rural women from different regions of Armenia to examine potential impacts on reproductive function and newborns. Breast milk samples (n = 266) from randomly selected mothers from the Aragatsotn region (1993–2000) were analyzed for OCPs: gamma-hexachlorocyclohexane (γ-HCH), p,p′-dichlorodiphenyltrichloroethane (p,p′-DDT), p,p′-dichlorodiphenyldichloroethylene (p,p′-DDE) and p,p′-dichlorodiphenyldichloroethane (p,p′-DDD). Samples collected during the study year were analyzed in the same year using gas chromatography with an electron capture detector. The results are presented as mean OCP levels in μg/L of whole milk and were compared between two subgroups: unexposed (n = 48) and exposed (n = 218), depending on birth order, anthropometric parameters of newborns, pregnancy and delivery course, etc. The predominant pollutants were p,p-DDE and γ-HCH. In primiparous women, p,p′-DDE level was 3% higher than in multiparous women. Pregnancy and childbirth complications were observed more frequently in the exposed group, but no significant differences were found. Maternal OCP concentrations were not associated with effects on fetal growth and birth sex ratio. This study contributes to the implementation of the Stockholm Convention on POPs by providing long-term data on OCP levels in breast milk and their potential impact, thereby contributing to sustainable development in Armenia.

Safely Supporting the Establishment of Breastfeeding in the Setting of Fentanyl Use Before the Birth Hospitalization.

To develop and validate a model for predicting upcoming discharge home of preterm infants in a level 2 neonatal ward. This retrospective cohort study included preterm infants admitted to the two-location study site between January 2016 and December 2023. A multivariable logistic regression model was developed using backward selection, with day 7 of admission selected as the prediction time. Primary outcome was discharge within one week (i.e. between admission day 7 and 14). On our wards, discharge required a minimum postconceptional age (PCA) of 35 weeks. Thus, infants with a PCA < 33 weeks at admission were excluded. The 1083 infants included were allocated to the development (n = 614) or validation (n = 469) set. Nine predictors were identified: mode of delivery, syndromal diagnoses, gestational and postconceptional age, tube feeding, provision of mother's own milk, weight, monitor surveillance, and caffeine administration. Internal and external validation showed excellent discrimination (AUC 0.93, CI 0.90-0.95) and acceptable calibration (slope 1.13, CI 0.91-1.35; intercept -0.14, CI -0.45 to 0.16). A probability threshold of 0.60 provided a sensitivity of 88% and specificity of 89%. A combination of perinatal and neonatal characteristics can adequately predict upcoming discharge home of preterm infants in a level 2 neonatal setting. Although models estimating total length of hospital stay in preterm infants have been reported, no models predict upcoming discharge, and the level 2 neonatal population remains underreported. We developed a tool to estimate the odds of discharge home within one week from the time of prediction, identifying nine (mainly clinical neonatal) predictors. The tool showed excellent discrimination and acceptable calibration, providing high sensitivity and specificity. The tool could optimize parent-provider communication and hospital capacity management, and should be validated further in prospective studies.

Maternal body mass index and association with breast milk intake in three-month-old infants.

The role of bacterial glycosyl hydrolases (GHs) in degrading free human milk oligosaccharides is well documented. However, their activity on glycoconjugates is less well known. Here, an in silico analysis of the metagenome of the fecal microbiome of breastfed infants was employed to identify GH2 β-galactosidases, GH20 exo-N-acetylglucosaminidases and GH18 endo-N-acetylglucosaminidases active on N-glycans. A total of nine β-galactosidases were recombinantly expressed and two of them, Gal1b and Gal99, were able to remove galactose from the G2 peptide and asialofetuin. Gal1b, Gal25, Gal37c, Gal99 and Gal296 hydrolyzed lactose and N-acetyllactosamine, indicating specificity for galactose β1,4-linked to glucose or GlcNAc. All of the exo-β-N-acetylglucosaminidases studied here (Exo10a, Exo18, Exo38, Exo39b, Exo360 and Exo399) hydrolyzed the disaccharide N-acetylglucosaminyl-β1,2-mannose, which forms part of the N-glycan structures. Exo10a, Exo38 and Exo360 hydrolyzed N-acetylglucosamine (GlcNAc) from the G2 peptide pretreated with Gal1b. Notably, Exo360 hydrolyzed GlcNAc at both the α1,3 and α1,6 branches of the G2 peptide core mannose simultaneously, whereas Exo10a showed a preference for GlcNAc at one branch. Exo38 and Exo360 also release GlcNAc from asialofetuin once galactose has been removed. The whole structures of N-glycans were liberated from glycoproteins by the action of the endo-N-acetylglucosaminidases Endo38 and Endo358. These enzymes hydrolyze the N,N'-diacetylchitobiose core of N-linked glycans of the high-mannose and non-sialylated complex types, respectively. Overall, these results provide insight into the range of glycosyl hydrolases present in the infant gut microbiota that act on glycoconjugates, which may play a role in the establishment and composition of the newborn microbiota.

Historical medical texts occasionally preserve therapeutics of unexpected modern relevance. This hypothesis-generating review presents a new translation and interpretation of human milk-based ophthalmic remedies in the Ebers papyrus (∼1550 BC) and evaluates their potential applicability to contemporary dry eye disease. Growth factors abundant in human milk parallel those delivered by autologous serum tears, and emerging evidence, including animal models and limited clinical studies, demonstrates that both human milk and bovine colostrum can promote corneal epithelial healing and reduce ocular surface inflammation. Given the high cost of current therapies and the ethical constraints surrounding donor human milk, bovine colostrum represents a low-cost, scalable alternative warranting further investigation. This historical-biomedical synthesis illustrates how ancient medical practices may inform modern strategies for managing refractory ocular surface disease.