Infant Human Milk Research Articles

Breastfeeding Characteristics and Duration of Feeding Human Milk in Infants With Congenital Heart Disease.

Breastfeeding Characteristics and Duration of Feeding Human Milk in Infants With Congenital Heart Disease.

Breastfeeding and human milk in the NICU: From birth to discharge.

It is well recognized that human milk is the optimal nutritive source for all infants, including those requiring intensive care. This statement reviews evidence supporting the importance of breastfeeding and human milk for infants, and why breastfeeding practices should be prioritized in the neonatal intensive care unit (NICU). It also reviews how to optimally feed infants based on their stability and maturity, and how to support mothers to establish and maintain milk production when their infants are unable to feed at the breast.

Bacillus Cereus prevalence in human milk donations in a North Italy human milk bank

Abstract Background The importance of human milk in infants’ diets is well-known in the medical community. Unfortunately, breastfeeding isn't always possible for various reasons, human milk donation represents the main solution to this problem. The donated milk goes through a pasteurization treatment (62.5 °C for 30 minutes). Before consumption, the milk is tested to analyze the microbiological safety aspect, specifically: the protocol of a North Italian bank, provides for the total count of microorganisms and of Bacillus Cereus. The presence of B. Cereus in pasteurized milk samples has been witnessed in the last few years. B. Cereus infections in infants have consistently been reported and banked human milk could be one of the possible sources. This work aims to study the prevalence of B. Cereus in banked human milk sampled before and after pasteurization treatment. Methods Between 2020 and 2023 we tested 1055 samples, before and after the pasteurization treatment. The enumeration of B. cereus is performed in accordance with ISO 7932:2004. 100 µL of pure raw milk and two consecutive decimal dilutions in buffered peptone water were seeded on Bacillus cereus Agar (BCA) at 30° for 24h-48h. B. Cereus strains isolated were typed using the hemolysis test and BCA. Results We found 46 samples positives for B. Cereus from 1055 samples analyzed before the heat treatment. The number increased to 57 in the pasteurized samples. These data are confirmed by the typing of the isolated strains from the human milk. Conclusions The 4% of not pasteurized milk is discarded due to B. Cereus presence, and the rate increase to 5% in pasteurized milk. This information suggests that the heat treatment isn't capable to inhibit all the B. Cereus, and the increase of B. Cereus from not pasteurized to pasteurized need to be studied. Key messages • B. Cereus represents one of the main causes of noncompliance in banked human milk. • Implementation of preventive/corrective actions is needed to prevent the contaminations led by the operators.

Investigation of Lactation Period and Technological Treatments on Mineral Composition and IR-Profiles of Donkey Milk by Chemometrics

Donkey milk represents an efficient substitute for human milk in infants’ diets being unlikely to cause allergic reactions. In this study, different donkey milks were collected at two lactation times (T0 and T1), subjected to freezing–thawing and freeze-drying, and analyzed by Inductively Coupled Plasma–Optical Emission Spectroscopy (ICP-OES) and ATR-FT-IR. The data collected on freeze–thaw (FT-) and reconstituted (R-)milks were investigated by ANOVA–Simultaneous Component Analysis (ASCA) and Principal Component Analysis (PCA). The following concentrations (µg/mL) for FT and R-milks, respectively, at T0, were found: Ca: 712 ± 71, 600 ± 72; Fe: 0.7 ± 0.3, 0.1 ± 0.1; K: 595 ± 49, 551 ± 59; Mg: 75 ± 5, 67 ± 4; Na: 117 ± 16, 114 ± 16; P: 403 ± 30, 404 ± 38; Zn: 1.6 ± 0.2, 1.6 ± 0.3. At T1, the concentrations (µg/mL for FT and R-milks, respectively) were: Ca: 692 ± 60, 583 ± 43; Fe: 0.13 ± 0.02, 0.13 ± 0.03; K: 641 ± 71, 574 ± 61; Mg: 72 ± 4, 63 ± 1; Na: 116 ± 9, 109 ± 8; P: 412 ± 30, 405 ± 24; Zn: 1.6 ± 0.3, 1.6 ± 0.3. ASCA demonstrated the treatment has a substantial effect, and PCA revealed that the largest quantities of metals, specifically Fe, Mg, and Ca for T0 and K, P, and Na for T1, are present in the FT-milk samples. The IR spectra of FT- and R-milks revealed no macroscopic changes among them or between lactation periods, indicating this technique may not suitably capture variability in lactation or conservation processes in donkey milk. Despite the relatively small sample size, this study offers insight on the mineral composition changes in donkey milk and emphasizes the significance of milk preprocessing and the lactation period on it.

Safety of 3-fucosyllactose (3-FL) produced by a derivative strain of Escherichia coli K-12 DH1 as a novel food pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 3-fucosyllactose (3-FL) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human-identical milk oligosaccharide (HiMO) 3-FL, but it also contains d-lactose, l-fucose, 3-fucosyllactulose and a small fraction of other related saccharides. The NF is produced by fermentation by a genetically modified strain (Escherichia coli K-12 DH1 MDO MAP1834) of E. coli K-12 DH1 (DSM 4235). The information provided on the manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant formula and follow-on formula, food for special medical purposes and food supplements (FS). The target population is the general population. The anticipated daily intake of 3-FL from both proposed and combined (authorised and proposed) uses at their respective maximum use levels in all population categories does not exceed the highest intake level of 3-FL from human milk in infants on a body weight basis. The intake of 3-FL in breastfed infants on a body weight basis is expected to be safe also for other population groups. The intake of other carbohydrate-type compounds structurally related to 3-FL is also considered of no safety concern. FS are not intended to be used if other foods with added 3-FL or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.

An equitable, community-engaged translational framework for science in human lactation and infant feeding—a report from “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” Working Group 5

Human milk is the ideal source of nutrition for most infants, but significant gaps remain in our understanding of human milk biology. As part of addressing these gaps, the Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN) Project Working Groups 1–4 interrogated the state of knowledge regarding the infant–human milk–lactating parent triad. However, to optimize the impact of newly generated knowledge across all stages of human milk research, the need remained for a translational research framework specific to the field. Thus, with inspiration from the simplified environmental sciences framework of Kaufman and Curl, Working Group 5 of the BEGIN Project developed a translational framework for science in human lactation and infant feeding, which includes 5 nonlinear, interconnected translational stages, T1: Discovery; T2: Human health implications; T3: Clinical and public health implications; T4: Implementation; and T5: Impact. The framework is accompanied by 6 overarching principles: 1) Research spans the translational continuum in a nonlinear, nonhierarchical manner; 2) Projects engage interdisciplinary teams in continuous collaboration and cross talk; 3) Priorities and study designs incorporate a diverse range of contextual factors; 4) Research teams include community stakeholders from the outset through purposeful, ethical, and equitable engagement; 5) Research designs and conceptual models incorporate respectful care for the birthing parent and address implications for the lactating parent; 6) Research implications for real-world settings account for contextual factors surrounding the feeding of human milk, including exclusivity and mode of feeding. To demonstrate application of the presented translational research framework and its overarching principles, 6 case studies are included, each illustrating research gaps across all stages of the framework. Applying a translational framework approach to addressing gaps in the science of human milk feeding is an important step toward the aligned goals of optimizing infant feeding across diverse contexts as well as optimizing health for all.

Fat Supplementation of Human Milk with MCT Oil for Promoting Weight Gain in Preterm Infants

Background: The addition of medium chain triglycerides is preferable as they are more easily digested and quickly absorb in bloodstream than long chain fat and provide ready supply of energy by increasing fatty acid bioavailability. Modular products like micro lipids and medium-chain triglyceride (MCT) oils are now focused as a fat supplementation. The rate of weight gain with MCT is not well known, and there is very less research done in Pakistan. Objective: To determine the effect of MCT oil supplemented human milk compared with un supplemented human milk fed to preterm infants on promoting weight gain. Study Design: Randomized controlled trial Study Setting: This study was conducted in Department of Neonatology, Children Hospital, PIMS, Islamabad, Pakistan from 20th August 2022 to 20th February 2023. Methodology: The study conducted after approval from institutional ethical committee. A total of 160 preterm infants fulfilling the inclusion criteria and enrolled in the study after informed consent from parents. The patients were receiving enteral feeding of human milk within neonatology department of hospital was included and they were randomly assigned to Group NF (receiving 20 ml of human milk without MCT oil), Group F (receiving 20ml of human milk with 1 ml of MCT oil fat). Primary outcomes were including growth in term of weight gain at measured at 1st ,5th and 10th day of MCT oil intake after hospital admission. Secondary outcome included feeding intolerance, diarrhoea, sepsis and necrotising enterocolitis. All the data was collected in the form of a questionnaire. The statistical analysis was done by using SPSS version 20. Results: One sixty very low birth weight infants were analyzed in this study. All infants were randomly divided into two groups: F and NF, the demographic details. The weight of infants was measured on first day, fifth day and tenth day and noted that the frequency of infants improved the weight gain after taking human milk without fat supplementation or human milk with fat supplementation. We found the gradually infants more increasing their weights in Group F as compared to Group NF. On tenth day 75% infants reaches between1400-1490 gm weight (p<0.001). The average daily gain in weight of Group F infants (g/kg). 12.2 Group A, 13.6 in group B were calculated on day first. The average daily weight was shifted in Group B from 13.6 to 14.9 on day fifth then it was further increased as 15.6 in Group C, and 15.8 in Group D. Practical Implication: The fat in the milk of humans is a significant source of energy. In an underdeveloped State like Pakistan that is short on resources, (MCT) oil can be a useful substitute for MCT due to its high MCT content. Few research studies have been conducted into this area thus far. Previous studies have had a low number of participants and produced contradictory findings. Therefore, this study was carried out to compare the efficacy of feeding preterm infants human milk supplemented with MCT oil to that of feeding them human milk without the supplement. Conclusion: Our study shows the average weight gain in those infants fed fat supplementation of MCT oil added in breast milk. The study provides data regarding the selection and use of fat supplemented human milk over non-supplemented human milk and this reduces the morbidity and mortality rate due to insufficiency of nutrients. Keyword: Fat supplementation, MCT oil, breast milk, preterm infants, weight gain rate.

Breastfeeding Characteristics and Duration of Feeding Human Milk in Infants With Congenital Heart Disease.

Although infants with congenital heart disease (CHD) are able to breastfeed successfully, the factors that affect feeding human milk across the first year are not well established. The objective of this study was to examine breastfeeding characteristics and their relationships to the exclusivity and duration of feeding human milk among infants with CHD. Breastfeeding characteristics data from a cohort of 75 infants with CHD enrolled in a study that examined relationships among milk type and infant growth in the first year of life were analyzed. Infants whose mothers reported not having enough milk were exclusively fed human milk for a shorter duration than those who did not have this challenge ( P = .04); however, the duration of feeding any human milk did not differ ( P = .18). Average daily volume expressed at 1 month was positively related to the duration of exclusive human milk (β = .07, P = .04) and any human milk (β = .07, P = .04) feeding. Future efforts to support feeding human milk in infants with CHD should emphasize practices that support maximal human milk production.

Impact of the COVID-19 pandemic on infant feeding practices in the United States: Food insecurity, supply shortagesand deleteriousformula-feeding practices.

The coronavirus disease 2019 (COVID-19) pandemic increased food insecurity among UShouseholds, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with UScaregivers of infants under 2 yearsof age (N = 319) to assess how the COVID-19 pandemic impacted breastfeeding, formula-feedingand household ability to obtain infant-feeding supplies and lactation support (68% mothers; 66% White; 8% living in poverty). We found that 31% of families who used infant formula indicated that they experienced various challenges in obtaining infant formula, citing the following top three reasons: the formula was sold out (20%), they had to travel to multiple stores (21%)or formula was too expensive (8%). In response, 33% of families who used formula reported resorting to deleterious formula-feeding practices such as diluting formula with extra water (11%) or cereal (10%), preparing smaller bottles (8%)or saving leftover mixed bottles for later (11%). Of the families who fed infants human milk, 53% reported feeding changes directly as a result of the pandemic, for example, 46% increased their provisioning of human milk due to perceived benefits for the infant's immune system (37%), ability to work remotely/stay home (31%), concerns about money (9%) or formula shortages (8%). Fifteen percentof families who fed human milk reported that they did not receive the lactation support they needed and 4.8% stopped breastfeeding. To protect infant food and nutrition security, our results underscore the need for policies to support breastfeeding and ensure equitable and reliable access to infant formula.

Impact of Donor Human Milk in an Urban NICU Population.

The American Academy of Pediatrics recommends the use of donor human milk in infants when mother's own milk is not available. Our objective was to analyze whether the use of donor human milk in preterm, very-low-birth-weight (VLBW, <1500 g) infants affected the rates of necrotizing enterocolitis, duration of parenteral nutrition (PN), growth, culture-positive sepsis, length of hospital stay, and mortality in an urban NICU population with low exclusive breast-feeding rates. A retrospective cohort study was conducted comparing two 2-year epochs of VLBW neonates before and after the introduction of donor breast milk in our neonatal intensive care unit (NICU). With the introduction of donor human milk, there was a significant reduction in the rate of necrotizing enterocolitis (NEC) (5% vs. 13%; p = 0.04) and less severe NEC as defined by Stage III based on the Modified Bell Staging Criteria (10% to 3%; p = 0.04). In the donor milk era, there was earlier initiation of enteral feeding (2.69 days vs. 3.84; p = 0.006) and a more rapid return to birthweight (9.5 days. 10.9 days; p = 0.006). In this study, a change in practice to the use of donor breast milk in a population with low rates of human milk provision was associated with earlier initiation of enteral feeding, faster return to birth weight, and a reduced incidence of NEC.

Safety of 3-fucosyllactose (3-FL) produced by a derivative strain of Escherichia coli BL21 (DE3) as a Novel Food pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 3‐fucosyllactose (3‐FL) as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human‐identical milk oligosaccharide (HiMO) 3‐FL, but it also contains d‐lactose, l‐fucose, d‐glucose and d‐galactose, and a small fraction of other related saccharides. The NF is produced by fermentation with a genetically modified strain of Escherichia coli BL21 (DE3). The information provided on the manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant formula and follow‐on formula, food for infants and young children, food for special medical purposes and food supplements. The target population is the general population. The anticipated daily intake of 3‐FL from both proposed and combined (authorised and proposed) uses at their respective maximum use levels in all population categories does not exceed the highest intake level of 3‐FL from human milk in infants on a body weight basis. The intake of 3‐FL in breastfed infants on a body weight basis is expected to be safe also for other population groups. The intake of other carbohydrate‐type compounds structurally related to 3‐FL is also considered of no safety concern. Food supplements are not intended to be used if other foods with added 3‐FL or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.

Safety of 3'-sialyllactose (3'-SL) sodium salt produced by derivative strains of Escherichia coli BL21 (DE3) as a Novel Food pursuant to Regulation (EU) 2015/2283.

Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver an opinion on 3’‐sialyllactose (3’‐SL) sodium salt as a novel food (NF) pursuant to Regulation (EU) 2015/2283. The NF is mainly composed of the human‐identical milk oligosaccharide (HiMO) 3’‐SL, but it also contains d‐lactose, 3’‐sialyllactulose, sialic acid, N‐acetyl‐d‐glucosamine and a small fraction of other related oligosaccharides. The NF is produced by fermentation with two genetically modified strains of Escherichia coli BL21 (DE3), the production strain and the optional degradation strain. The information provided on the manufacturing process, composition and specifications of the NF does not raise safety concerns. The applicant intends to add the NF to a variety of foods, including infant formula and follow‐on formula, food for infants and young children, food for special medical purposes and food supplements. The target population is the general population. The anticipated daily intake of 3’‐SL from both proposed and combined (authorised and proposed) uses at their respective maximum use levels in all population categories does not exceed the highest intake level of 3’‐SL from human milk in infants on a body weight basis. The intake of 3’‐SL in breastfed infants on a body weight basis is expected to be safe also for other population groups. The intake of other carbohydrate‐type compounds structurally related to 3’‐SL is also considered of no safety concern. Food supplements are not intended to be used if other foods with added 3’‐SL or human milk are consumed on the same day. The Panel concludes that the NF is safe under the proposed conditions of use.

Does breastfeeding influence sleep? A longitudinal study across the first two postpartum years.

BackgroundThe association between breastfeeding and sleep of the gestational parent is poorly understood. This longitudinal study investigated how breastfeeding is associated with total nighttime sleep duration and sleep efficiency (percentage of total sleep time in bed) in nulliparous participants over the first two postpartum years.MethodsNulliparous participants (N = 155, Mage = 33.45, SDage = 3.50) self‐reported patterns of breastfeeding via telephone interviews and sleep via self‐report at 1.5, 3, 6, 12 and 24 months postpartum. Data were analyzed using mixed‐effects models, with breastfeeding variables as predictors and sleep variables as outcomes, controlling for relevant covariates.ResultsNeither the presence of breastfeeding nor the percentage of human milk in infants' total diets was significantly associated with participants' sleep duration or sleep quality (P‐values > 0.08). This finding held after controlling for the number of nighttime feeds (P‐values > 0.11). However, greater numbers of nighttime feeds, regardless of feeding content, were strongly associated with shorter sleep duration and poor sleep efficiency (P‐values < 0.05). On average, with each additional nighttime feed, nocturnal sleep duration decreased by 6.6‐8.4 minutes, and sleep efficiency decreased by 2.88%‐3.02%.ConclusionsData from this study showed that breastfeeding per se was not associated with shorter or poor nocturnal sleep, but the number of nighttime feeds was. Sharing nighttime infant care amongst different carers in the household could help reduce postpartum sleep disturbance and ameliorate its negative impact on wellbeing.

The Impact of Human Milk on Outcomes for Infants with Congenital Heart Disease: A Systematic Review.

Background: Infants with congenital heart disease (CHD) are at risk for feeding-related morbidity and mortality, with growth failure and oral feeding problems associated with poor outcomes. The benefits of human milk (HM) for preterm infants have been well documented, but evidence on HM for infants with CHD has recently begun to emerge. Objectives: Our primary aim was to examine the impact of HM feeding on outcomes for infants with CHD. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a search was conducted using MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews. The quality of each study was assessed using the Joanna Briggs Critical Appraisal Tools. A total of 16 studies were included. Results: There was evidence that an exclusive HM diet reduces the risk of necrotizing enterocolitis (NEC) for infants with CHD. Evidence with a higher risk for bias indicated that a well-managed HM diet may be associated with improved growth, shorter length of stay, and improved postoperative feeding and nutritional outcomes. Chylothorax outcomes were similar between modified HM and medium-chain triglyceride formula. The studies had significant limitations related to power, lack of control for covariates, and inconsistent delineation of feeding groups. Conclusions: Based on the reduced risk for NEC and given the conclusive benefits in other vulnerable populations, we recommend that clinicians and institutions prioritize programs to support HM feeding for infants with CHD. Large high-quality studies are needed to validate these results. Future work should clarify best practices in managing an HM diet to support optimal growth and development for these infants.

Nutrients and Bioactive Components of Human Milk After One Year of Lactation: Implication for Human Milk Banks.

Specifying the nutrient content and bioactive compounds in milk from long-term lactation for the purpose of finding additional sources of donors' milk for human milk banks. Human milk samples were collected from 43 mothers of term infants (term infant human milk, TIHM) (3-6 weeks of lactation) and 50 mothers who have breastfed for over a year (long-nursing human milk, LNHM). The milk collection time was 24 hours. The analyses of fat, protein, carbohydrate and energy content were performed with human milk analyzer MIRIS (Miris HMA™ ); lactoferrin and vitamin C content using high performance liquid chromatography in reversed phase (RP-HPLC); total antioxidant activity (TAC) and lysozyme by enzyme-linked immunosorbent assay (ELISA); and the activity of glutathione peroxidase (GPx) and catalase (CAT) via spectrophotometric methods. Sociodemographic characteristics of both groups of mothers have been compiled. Higher fat content and energy value was found in LNHM than in TIHM. Protein content in LNHM and TIHM did not differ. Carbohydrate content was lower in LNHM than in TIHM. TAC, CAT and GPx activity were higher in LNHM compared to TIHM. No significant differences in the content of lysozyme, lactoferrin and vitamin C between the studied groups were found. The findings suggest that after 12 months of lactation, human milk still has significant nutritional value, does not lose bioactive components and can be considered for use in human milk banks.

The Abundance of Human Milk Oligosaccharide (HMO)-Metabolizing Genes in Fecal Samples from Six-Month-Old Human Infants.

Herein, we report the abundance and prevalence of HMO-metabolizing genes, specifically those of Bifidobacterium infantis, in fecal samples from human infants. Forty dyads were enrolled, and each mother collected a fecal sample from her infant at six months of age. Genomic DNA was extracted, and quantitative real-time PCR was used to determine gene abundance. The mode of delivery was not associated with gene abundance. Several gene regions, Sia (a sialidase), B. inf (16S), and GH750 (a glycoside hydrolase), were more abundant in the feces of human milk-fed infants (p < 0.05). Others, Sia and HC bin (16S), tended to be less abundant when a larger percentage of an infant’s diet consisted of solids (p < 0.10). When accounting for solid food intake, human milk exposure was positively associated with Sia and B. inf (p < 0.05) and tended to be related to the abundance of the GH750 and HC bin (p < 0.10) gene regions. With further development and validation in additional populations of infants, these assays could be used to group samples by dietary exposure even where no record of dietary intake exists. Thus, these assays would provide a method by which infant human milk intake can be assessed quickly in any well-equipped molecular biology laboratory.

Human Milk Oligosaccharide (HMO) Metabolizing Gene Abundances in Human Infant Fecal Samples

ObjectivesTo benefit from the complex oligosaccharides found in human milk, an infant relies on microbial metabolism of these compounds. The main objective of this study was to determine the abundance of Bifidobacterium infantis human milk oligosaccharide (HMO) metabolizing genes in infant fecal samples. MethodsFecal samples from 40 6-mos-old infants were collected. Genomic DNA was extracted, and quantitative real-time PCR was used to determine the abundance of several genes in B. infantis. B infantis specific primer sets were used to target 5 HMO metabolizing genes as well as the 16S rRNA gene. Additional 16S rRNA primer sets were used to target overall bacteria, overall Bifidobacterium, B. breve and B. longum. Abundances of each qPCR reaction were compared by infant human milk exposure, solid food intake, and mode of delivery. ResultsMode of delivery was not associated with any PCR targets. Two HMO genes, a sialidase and a glycoside hydrolase, as well as a B. infantis 16S rRNA gene were more abundant in the feces of human milk fed infants (p < 0.05). The sialidase and a B. infantis 16S rRNA gene tended to be less abundant when a larger percentage of an infant’s diet consisted of solids (p < 0.10). When accounting for solid food intake, human milk exposure continued to be positively associated with the sialidase and a B. infantis 16S rRNA gene abundance (p < 0.05) and tended to be related to the abundance of the glycoside hydrolase (p < 0.10). An assessment of 5 B. infantis specific primer sets targeting HMO metabolizing genes demonstrated that the stools of human milk fed infants harbored a more diverse set of these genes than those of non-human milk fed infants (p = 0.02). ConclusionsHerein, we have identified a qPCR primer set targeting a sialidase that is consistently associated with human milk exposure even in the presence of solid food intake. With further development and validation in additional populations of infants, these assays could be used to group samples by dietary exposure even where no record of dietary intake exists. Thus, this assay would provide a method by which infant human milk intake proximal to sample collection can be assessed quickly in any well-equipped molecular biology lab. Funding SourcesThis research was partially supported by the MSU College of Agriculture and Natural Resources Undergraduate Research Program as well as the Max Gonzenbach Research Scholarship.

Antimicrobial Effect of Zn2+ Ions Governs the Microbial Quality of Donor Human Milk.

Donor human milk (HM) obtained at HM banks is exceptionally crucial for the feeding and treatment of preterm infants. Bacterial contaminations of HM in various stages of its handling are very common and can lead to disqualification of donations or severe infections in worse cases. Hence, HM donations are subject to strict bacteriological evaluations pre- and post-pasteurization. The main contaminating species vary between countries, banks and donors and even exhibit inter-individual variation. We initiated an assessment of the bacteriological composition of HM donated by women hospitalized in a neonatal intensive care unit in Israel. The most common bacterium identified was Staphylococcus epidermidis, found in all but one of the HM samples; the presence of several species of coagulase-negative Staphylococci was also noted. Next, we sought to develop a platform towards antibacterial treatment using Zn2+ ions that have recently been found to be potent against contaminants isolated from bovine milk. Zn2+ efficiently inhibited the growth of viable aerobic population and S. epidermidis in HM. Growth was also inhibited in other Gram-positive bacteria such as Bacillus cereus, a well-known food-borne pathogen. S. epidermidis and B. cereus cells grown in the presence of zinc were taken for microscopic evaluation, aiming to demonstrate zinc’s antimicrobial mode of action morphologically. Images obtained using scanning electron microscopy indicated leakage of cellular content and cell lysis in S. epidermidis. Besides, B. cereus cells showed abnormalities in their cell surface and complete loss of flagella upon treatment with zinc. Along with the above findings, it should be noted that this was a pilot study that tested how high doses of Zn2+ affect breast milk as a product. Further research is likely needed on the safety of consumption of Zn2+-treated HM in infants and older children.

Human and Donor Milk Use Post NICU Discharge

Background: The health benefits of feeding all infants human milk are well established but the use of human milk after infants are discharged from the Neonatal Intensive Care Unit (NICU) remains low. Aims: Our aim was to investigate which infants were receiving human milk at discharge from the NICU and at varying times after discharge and to explore factors that foster or inhibit increasing human milk use in NICU graduates. Methods: We conducted a prospective, observational study and collected data on the use of human milk at hospital discharge and during follow-up visits in five developmental follow-up programs. These follow up programs were in 5 different large cities in 3 different states in the United States. Results: The overall rate of use of any human milk decreased from 841/1,160 (72.5%) at discharge to 233/791 (29.5%) in participants who were followed for &gt;4 and ≤7 months after birth and this trend continued with later follow-up. In a multivariate logistic analysis, the factors found to be independently associated with the use of human milk at follow-up were: use of human milk at discharge (AOR=39.3, 14-162); white race compared to all other races/ethnicity (AOR= 2.97, 2.1-4.2); being reported preterm at birth (&lt;=32 weeks) compared to more mature gestational age infants (AOR= 2.02, 1.4-2.9); and mother having received a breast pump within 12 hours of the birth of her infant (AOR=1.90, 1.2-3). Conclusions: Health care practices within the NICU affect the continued use of human milk after infants are discharged from the hospital. These practices could be enhanced to increase human milk usage in NICU graduates.

Human Milk Intake of Thai Breastfed Infants During the First 6 Months Using the Dose-to-Mother Deuterium Dilution Method.

Data on infant human milk intakes in low- and middle-income countries are limited, although the deuterium oxide dose-to-mother method (DTM) is an accurate tool for its estimation. We assessed human milk intakes of Thai infants during the first 6 months comparing exclusive breastfeeding (EBF), predominant breastfeeding (PBF), and partial breastfeeding (PartBF). One hundred and ten healthy Thai lactating mother-infant pairs were followed from birth. Human milk intakes were determined at 6 weeks, 3 months, and 6 months using the DTM method. Daily energy and protein intakes were assessed using 3-day nonconsecutive 24-hour recalls. Sociodemographic characteristics were collected using a questionnaire. To compare breastfeeding practices, one-way analysis of variance with Tukey post hoc test assessed normally distributed data, while the Kruskal-Wallis test with Mann-Whitney U test was used for not normally distributed data. No difference existed in human milk intakes during the first 6 months between EBF (743-776 g/d) and PBF (748-862 g/d). Human milk intakes of PartBF infants were significantly lower compared to other infants. Human milk intake was sufficient to meet infant energy and protein requirements during the first 3 months for EBF and PBF groups. Infant formula largely replaced human milk during the first 3 months; other solid foods were also introduced among the PartBF infants. Human milk intakes were comparable between EBF and PBF infants during the first 6 months and provided adequate energy and protein to meet requirements. Infant formula largely replaced breast milk among PartBF infants, although other foods were also given early. This study was registered at clinicaltrials.gov as NCT04020640.