Breast Milk Research Articles

Effect of In Vitro Digestion on Bioactive Peptides Related to Immune and Gut Health in Intact Cow's Milk and Hydrolyzed Protein-Based Infant Formulas.

Background/Objectives: Human milk is the optimal source of nutrition and protection against infection for infants. If breastfeeding is not possible, standard and hydrolyzed infant formulas (IF) are an alternative. Extensively hydrolyzed IFs (eHFs) contain bioactive peptides, but their activities have rarely been evaluated. The aim of this study was to characterize and compare the bioactive peptide profiles of different eHFs and standard IFs before and after in vitro digestion. Methods: Two forms, liquid and powder, of intact protein formula (iPF) and eHF were subjected to in vitro gastrointestinal digestion, mimicking a young infant's gut (age 0-4 months) and an older infant's gut (>6 months). Bioactive peptides of in vitro digested and undigested formulas were analysed with Liquid Chromatography-Mass Spectrometry (LC-MS). Results: In all samples, a variety of peptides with potential bioactive properties were found. Immuno-regulatory peptides, followed by antimicrobial and antioxidative peptides were most frequent, as were peptides promoting wound healing, increasing mucin secretion, regulating cholesterol metabolism, and preventing bacterial infection. Peptides typically found in yoghurt and colostrum were identified in some formula samples. Conclusions: The high amounts of bioactive peptides with various properties in eHFs and iPFs indicate a possible contribution to infection protection, healthy gut microbiomes, and immunological development of infants. eHFs showed similar compositions of bioactive peptides to iPFs, with intermittently increased peptide variety and quantity.

The Importance of Motivational Interviewing Technique in Providing Breastfeeding Motivation in the Postpartum Period

Breastfeeding is an important period in terms of mother and baby health. In order to benefit from breast milk at the maximum level during the breastfeeding process, it is important for the mother to start breastfeeding as soon as possible after birth and to be able to maintain breastfeeding. In this process, physiological, psychological, social and motivational factors have an effect on the continuity and maintenance of breastfeeding. If the mother experiences any breastfeeding problem during breastfeeding, her motivation to breastfeed may decrease. In recent studies, breastfeeding trainings have been applied with different techniques to encourage mothers to breastfeed during the breastfeeding process, to support them to feel competent and strong in this process and to increase their motivation for breastfeeding, adapted to their individual needs. One of these techniques is the motivational interview technique. Motivational interviewing technique has a supportive role in helping mothers to adapt to the breastfeeding process, to determine their attitudes towards breastfeeding, to address their lack of knowledge about breastfeeding, their concerns about this process, to increase their confidence and intrinsic motivation about breastfeeding, and to continue breastfeeding by helping behaviour change when necessary. In this article, the importance of motivational interviewing technique in providing breastfeeding motivation in the postnatal period is explained.

Cost of operating a human milk bank in the UK: a microcosting analysis

ObjectiveGlobally, demand for donor human milk (DHM) is increasing with WHO guidelines recommending DHM as the first line nutrition for premature infants in the absence or shortfall of maternal milk....

The human milk oligosaccharide 3'sialyllactose reduces low-grade inflammation and atherosclerosis development in mice.

Macrophages contribute to the induction and resolution of inflammation and play a central role in chronic low-grade inflammation in cardiovascular diseases caused by atherosclerosis. Human milk oligosaccharides (HMOs) are complex unconjugated glycans unique to human milk that benefit infant health and act as innate immune modulators. Here, we identify the HMO 3'sialyllactose (3'SL) as a natural inhibitor of Toll-Like Receptor (TLR) 4-induced low-grade inflammation in macrophages and endothelium. Transcriptome analysis in macrophages revealed that 3'SL attenuates mRNA levels of a selected set of inflammatory genes and promotes the activity of Liver X Receptor (LXR) and Sterol Regulatory Element-binding Protein-1 (SREBP). These acute anti-inflammatory effects of 3'SL were associated with reduced histone H3K27 acetylation at a subset of lipopolysaccharide (LPS)-inducible enhancers distinguished by preferential enrichment for CCCTC-binding factor (CTCF), Interferon Regulatory Factor 2 (IRF2), B-cell lymphoma 6 (BCL6), and other transcription factor recognition motifs. In a murine atherosclerosis model, both subcutaneous and oral administration of 3'SL significantly reduced atherosclerosis development and the associated inflammation. This study provides evidence that 3'SL attenuates inflammation by a transcriptional mechanism to reduce atherosclerosis development in the context of cardiovascular disease.

Synthesis of trisaccharide antigens featuring colitose, abequose and fucose residues and assessment of antibody binding on antigen arrays

Deoxy-hexose sugars, such as rhamnose and quinovose, and the dideoxy-hexoses colitose, abequose, and tyvelose are highly antigenic given that they are absent from animal glycoconjugates. To investigate the specificity of antibodies towards structurally similar carbohydrate epitopes found in bacteria, we synthesized trisaccharides containing colitose, abequose, and fucose motifs. Each trisaccharide was designed with a spacer ending with a primary amino group. These trisaccharide constructs were immobilized on O-succinimide coated glass slides alongside bacterial lipopolysaccharides (LPS) containing colitose, abequose, and fucose residues. We compared the recognition of the synthetic trisaccharides and natural LPS including structurally related epitopes by monoclonal and polyclonal antibodies targeting bacterial LPS. Additionally, we used arrays displaying the synthetic trisaccharides and natural LPS to assess the variability of IgA reactivity from breast milk samples towards the carbohydrate antigens. The results obtained underlined the cross-reactivity of polyclonal antibodies towards structurally related carbohydrate antigens and revealed a broad reactivity of breast milk-derived IgA towards the carbohydrate antigens tested. The significant cross-reactivity of antibodies towards structurally related LPS antigens may lead to false-positive detection of bacterial serotypes when used for diagnostic purposes.

Multi-residue analysis method based on QuEChERS followed by ultra-high performance liquid chromatography coupled with diode-array detector for pesticides in human serum and breast milk.

Background: Maternal fluids play a key role in the risk assessment regarding early life pesticide exposure as the chemicals can transfer to neonate through prenatal exposure and lactation.Aim: A developed UHPLC-DAD and modified QuChERS methods were validated for human serum and breast milk. Matrix effect of the biological samples were evaluated.Methods & results: Serum was extracted by unbuffered QuChERS method while breast milk was extracted by citrate buffered method with addition of hexane. Remaining lipid in breast milk extract was later removed using lipid-removal sorbent. Sample matrices caused huge impacted on low-sensitivity pesticides.Conclusion: The modified QuEChERS methods coupled with UHPLC-DAD were fully validated. Application in paired-serum and breast milk samples revealed 6 detected pesticides.

Impact of cultural, nutrition, and lifestyle transition on human milk composition between the Orang Asli communities in Peninsular Malaysia: A study protocol.

Background: Human milk provided by healthy, well-nourished mothers represents the best food available for infants. Human milk is species-specific and recommended as the sole source of nutrition for the first 6 months of life and is an important food source until the infants reach 2 years of life. Unlike infant formula, which has a standardized composition, human milk composition varies among and within women. Aim: While many studies of human milk composition have been conducted, none have been done among the Orang Asli people in Malaysia. Hence, this study protocol is designed to determine the human milk composition of the Orang Asli in Peninsular Malaysia and how the transition of culture, nutrition, and different lifestyle experiences will affect the nutrient content of their milk. Methods: Quantitative (interviewer-administered questionnaire) and qualitative (focus group discussion) approaches will be employed in this study and in addition, laboratory works will also be carried out to analyze the nutrient composition of the milk samples collected from various Orang Asli subethnic groups in Peninsular Malaysia. Conclusion: Standardized, multipopulation studies of human milk composition are sorely needed to create a rigorous, comprehensive reference inclusive of nutrients and other factors. The establishment of any dietary parameters positively affecting the nutrient content of human milk may help design healthcare strategies in Malaysia to improve the quality of human milk and therefore the infants' health status.

Research progress in the synthesis of 3'- and 6'-sialactose by Escherichia coli

Human milk oligosaccharides (HMOs) are a structurally complex group of unbound polysaccharides, representing the third-largest solid component in breast milk. They play a crucial role in the intestinal health and immune system development of infants. Sialylated HMOs, including 3'-sialactose (3'-SL) and 6'-sialactose (6'-SL), are major components of HMOs, playing significant roles in immune regulation, anti-inflammatory processes, and promotion of probiotic growth. Currently, the cost-effective production of high-value sialactose by microbial fermentation with readily available raw materials has become a research hotspot due to the high nutritional value and potential applications of sialylated HMOs in infant food. This paper summarizes the functions and biosynthesis of 3'-SL and 6'-SL. Furthermore, it reviews the research progress in the synthesis of sialactose by Escherichia coli, offering valuable insights for future industrial production.

Maternal oral probiotic use is associated with decreased breastmilk inflammatory markers, infant fecal microbiome variation, and altered recognition memory responses in infants-a pilot observational study.

Early life gut microbiomes are important for brain and immune system development in animal models. Probiotic use has been proposed as a strategy to promote health via modulation of microbiomes. In this observational study, we explore if early life exposure to probiotics via the mother during pregnancy and lactation, is associated with decreased inflammation in breastmilk, maternal and infant microbiome variation, and altered infant neurodevelopmental features. Exclusively breastfeeding mother-infant dyads were recruited as part of the "Mothers and Infants Linked for Healthy Growth (MILk) Study." Probiotic comparison groups were defined by exposure to maternal probiotics (NO/YES) and by timing of probiotic exposure (prenatal, postnatal, total). C-reactive protein (CRP) and IL-6 levels were determined in breastmilk by immunoassays, and microbiomes were characterized from 1-month milk and from 1- and 6-month infant feces by 16S rDNA sequencing. Infant brain function was profiled via electroencephalogram (EEG); we assessed recognition memory using event-related potential (ERP) responses to familiar and novel auditory (1 month) and visual (6 months) stimuli. Statistical comparisons of study outcomes between probiotic groups were performed using permutational analysis of variance (PERMANOVA) (microbiome) and linear models (all other study outcomes), including relevant covariables as indicated. We observed associations between probiotic exposure and lower breastmilk CRP and IL-6 levels, and infant gut microbiome variation at 1- and 6-months of age (including higher abundances of Bifidobacteria and Lactobacillus). In addition, maternal probiotic exposure was associated with differences in infant ERP features at 6-months of age. Specifically, infants who were exposed to postnatal maternal probiotics (between the 1- and 6-month study visits) via breastfeeding/breastmilk, had larger differential responses between familiar and novel visual stimuli with respect to the late slow wave component of the EEG, which may indicate greater memory updating potential. The milk of mothers of this subgroup of infants had lower IL-6 levels and infants had different 6-month fecal microbiomes as compared to those in the "NO" maternal probiotics group. These results support continued research into "Microbiota-Gut-Brain" connections during early life and the role of pre- and postnatal probiotics in mothers to promote healthy microbiome-associated outcomes in infants.

The Effectiveness of Chain Pumpkin on Improving Breast Milk Production and Increasing Baby's Weight

The Effectiveness of Chain Pumpkin on Improving Breast Milk Production and Increasing Baby's Weight

Whole-genome sequencing of bacteria accountable for lactational mastitis in humans combined with an examination of their antibiotic resistance profiles.

Lactational mastitis, a common condition affecting nursing mothers, is characterized by mammary gland inflammation during lactation. This inflammatory response typically occurs due to bacterial infection. The discomfort and pain associated with lactational mastitis can significantly impact a mother's ability to breastfeed comfortably and may lead to the cessation of breastfeeding altogether if left untreated. Antibiotics are commonly prescribed to target the bacteria causing the infection and alleviate symptoms, aiming to treat the infection. Nevertheless, a notable worry linked to antibiotic use is the emergence of antibiotic resistance, compounded by the possible persistence of antibiotics in milk. Additionally, lactational mastitis is characterized by its polymicrobial nature. In this study, bacteria were isolated from infected breast milk samples and whole-genome sequencing was performed on eleven isolates to accurately identify the bacteria and assess their antibiotic resistance profiles. Using Galaxy tools and the ResFinder database, we identified Bacillus paraanthracis, Bacillus altitudinis, Staphylococcus aureus, Bacillus cereus, Escherichia coli, Alcaligenes faecalis, and Bacillus licheniformis, along with antibiotic-resistant genes like fosB1, cat86, erm (D), blaZ, and mdf (A). ABRicate aided in antimicrobial resistance (AMR) gene analysis, and CARD visualized their distribution. Our study demonstrates that the severity of infection is directly proportional to an increase in somatic cell count (SCC). This research sheds light on microbial diversity in lactational mastitis milk and provides crucial insights into antibiotic-resistance genes. Utilizing bioinformatics tools, such as those employed in this study, can inform the design of effective treatment strategies for lactational mastitis infections.

Traditional weaning foods and processing methods with fortification for sustainable development of infants to combat zero hunger: a review.

Weaning foods are soft digestible baby foods introduced along with breast milk for infants of 6 to 24 months. Early nutrition is a crucial one for proper growth and wellbeing. Researchers have developed weaning food from locally available ingredients with appropriate processing methods without losing actual nutrients value. Despite this, micronutrient malnutrition irrespective of the country status is a potential threat. This is overcome by fortifying micronutrients in the formulated weaning foods. Typically, formulated weaning foods are prepared from fruits and cereal grains that are abundant in micronutrients. Different processing methods are adopted to maintain the original natural characteristics of the ingredients. Traditional homemade weaning foods always have an upper hand over industrialized ones. Additionally, fortification enhances the micronutrients in weaning food and helps in uprooting the hidden hunger thereby helping in the sustainable development goals. This review focuses and delivers insights on the various processing methods and cereal-fruit weaning foods as traditional homemade ready-to-serve food supplement. It also highlights the impact of fortification of weaning foods against micronutrient malnutrition. On the whole this work emphasizes on the importance of sustainable weaning foods and how babies can be brought up into healthy grown-ups achieving zero hunger.

The Role of Breastmilk in Macrophage-Tumour Cell Interactions in Postpartum Breast Cancer

Background: Lactation is associated with long-term reduced risk of breast cancer. However, there is a transient increased risk of breast cancer in the 5 to 10 years postpartum and this is associated with a high incidence of metastasis and mortality. Breastmilk is a physiological fluid secreted by the mammary glands intimately connected with breast cells and the microenvironment that may affect postpartum breast cancer development and progression. This study aims to investigate the effect of breastmilk on interactions between breast cancer cells and macrophages in vitro. Methods: Human breastmilk from healthy donors (n = 7) was pooled and incubated with breast cancer (MCF-7 and MDA-MB-231) and macrophage (RAW264.7) cell lines to assess cell proliferation, viability, migration, and expression of key genes associated with epithelial-mesenchymal transition (EMT) and macrophage phenotype. Indirect co-culture studies assessed the effect of breastmilk on interactions between breast cancer cells and macrophages. Results: Breastmilk increased the proliferation and viability of breast cancer cells, reduced EMT markers, and reduced cell migration in MDA-MB-231 cells. Breastmilk decreased mRNA expression of interleukin 1B (IL1B) and interleukin 10 (IL10) in macrophages. Reduced EMT marker expression was observed in breast cancer cells co-cultured with macrophages pre-treated with breastmilk. Macrophages co-cultured with breast cancer cells pre-treated with breastmilk exhibited increased expression of a pro-inflammatory cytokine tumor necrosis factor A (TNFA) and pro-inflammatory nitric oxide synthase 2 (NOS2), and reduced expression of cytokines IL10 and transforming growth factor B1 (TGFB1) which are associated with the alternatively-activated macrophage phenotype. Conclusions: Breastmilk has the potential to promote breast cancer proliferation, however, it can also reduce breast cancer progression through inhibition of breast cancer cell migration and regulation of macrophage polarisation. These findings suggest that breastmilk has potential to shape the tumour microenvironment in postpartum breast cancer.

Oxytocin Massage on Pain Levels and Breast Milk Production in Post Cesarean Section (Case Study)

Post cesarean section (CS) is a physiological condition that occurs in women who give birth via cesarean section or surgery. The changes include pain, uterine involution, breastfeeding (ASI) production, and psychological adjustments.. According to research, 20-80% of post CS patients experience moderate to severe pain that is inadequately managed. In Indonesia, this occurs at a rate of 30-80%. The effective breastfeeding rate in Indonesia is 55.5%, which does not yet meet the national target of 80%. Given the magnitude of these issues, the author aims to describe the influence of oxytocin massage application on pain levels and ASI production in post CS patients through this scientific work. The methodology used is a case study involving patients Mrs. L on their first day post CS. The intervention was applied from the second to the third day post CS, twice daily. The results of this application show that oxytocin massage can reduce pain from a scale of 7 to 3 and increase breast milk production, with a cumulative increase from no milk output to more than 50 cc.. It is hoped that the application of evidence-based nursing: oxytocin massage can be implemented as a standard intervention for post CS patients in hospitals.

Exposure and potential risks of thirteen endocrine- disrupting chemicals in pharmaceuticals and personal care products for breastfed infants in China

Ingestion of breast milk represents the primary exposure pathway for endocrine-disrupting chemicals (EDCs) in newborns. To elucidate the associated risks, it is essential to quantify EDC levels in both breast milk and infant urine. This study measured the concentrations of 13 EDCs, including parabens (methyl paraben (MP), ethyl paraben (EP), propyl paraben (PP), iso-propyl paraben, butyl paraben, and iso-butyl paraben), bisphenols (bisphenol A (BPA), bisphenol F, bisphenol S, bisphenol AF, and bisphenol Z), triclosan (TCS), and triclocarban, in breast milk and infant urine to assess their potential health effects and endocrine disruption risks. In total, 1 014 breast milk samples were collected from 20 cities across China, along with 144 breast milk samples and 134 urine samples from a mother-infant cohort in Hangzhou. The EDCs were detected using ultra-high-performance liquid chromatography-triple quadrupole mass spectrometry. Endocrine-disrupting potency was evaluated using a predictive method based on EDC affinity for 15 hormone receptor proteins. The toxicological priority index (ToxPi), incorporating population exposure data, was employed to assess health risks associated with exposure to multiple EDCs. Among the 13 EDCs, MP, EP, PP, BPA, and TCS were detected in over 50 % of breast milk samples, with the highest median concentrations observed for MP (0.37 ng/mL), EP (0.29 ng/mL), and BPA (0.17 ng/mL). Across the 20 cities, 0 %–40 % of infants had a hazard index (HI) exceeding 1. Based on affinity prediction analysis and estimated exposure, cumulative endocrine disruption risk intensity was ranked as MP > TCS > BPA > EP > PP. This research highlights the extensive exposure of Chinese infants to EDCs, offering a detailed analysis of their varying endocrine disruption potencies and underscoring the significant health risks associated with EDCs in breast milk.

Dietary nucleotides drive changes in infant fecal microbiota in vitro and gut microbiota-gut-brain development in neonatal rats: A potential “nitrogen source” for early microbiota growth

Various dietary factors in human milk are important nutrients for the formation of the infant gut microbiota (GM). While promoting the growth of the GM, some human milk components that are difficult to absorb and utilize will be broken down by the GM, and converted into nutrients that the baby can use, such as breast milk oligosaccharides—the ‘carbon source’ for infant GM. This study reveals that nucleotides (NTs), significant non-protein nitrogen sources in human milk, can enhance the abundance of beneficial microbial genera such as g_Bifidobacterium, g_Bacteroides, and g_Blautia in in vitro fecal fermentation fluids of infants at low doses (2 mg/mL). Conversely, high doses of NTs (20 mg/mL) increased the abundance of g_Escherichia-Shigella. Furthermore, low-dose NTs fermentation broth significantly enhanced the expression of neurodevelopmental marker genes such as Tuj1, Sox2, Dcx, and NeuN in NE-4C neural stem cells, whereas a single NTs digestion broth did not exhibit significant activity. However, in vivo studies using neonatal rats as a model demonstrated that both low-dose NTs fermentation broth and NTs digestive juices promoted behavioral development in neonatal rats (PND 20) and neuron maturation in the prefrontal cortex and hippocampus. Non-targeted metabolomics results indicate that low-dose dietary NTs promote the production of certain neuroregulatory metabolites in infant fecal fermentation, such as uridine, L-tyrosine, L-glutamic acid, and succinic acid. These findings suggest that NTs may serve as an important “nitrogen source” during GM formation in early life and have a dose effect in driving the development of the microbiota-gut-brain axis in early life.

Exploring trends of macronutrients in Danish human donor milk

Exploring trends of macronutrients in Danish human donor milk

Abstract A014: Racial and socioeconomic disparities in breast feeding and the impact of pregnancy-related medical conditions among a population-based sample of non-Hispanic Black and White women

Abstract Background: Breastfeeding has been associated with a reduced risk of breast cancer (BC), particularly with Triple Negative BC (TNBC). The risk of TNBC is higher among premenopausal women, Black/African American (AA) women, and poorer women. Notably there are significant disparities in breastfeeding, where non-Hispanic Black (NHB) women and poorer women are less likely to breastfeed in the United States. Studies have identified historical racial trauma, unsupportive work and hospital policies, breast milk formula advertising, and knowledge and beliefs about breast feeding as factors that contribute to breast feeding practices. However, there is a paucity of research on pregnancy related medical conditions (PMCs) that potentially impact initiation and duration of breastfeeding. The purpose of this study is to evaluate racial and socioeconomic differences in breastfeeding, and if PMCs impact breastfeeding practices in a population-based sample of non-Hispanic Black and White women. Method: Data are from the Young Women’s History and Health Study (YWHHS), a population- based case-control study of invasive BC among non-Hispanic Black (NHB) and non-Hispanic White (NHW) women aged 20-49 years residing in Metropolitan Detroit and Los Angeles County, 2010-2015. The analytic sample here includes the first pregnancy of control participants with singleton live births (n=675). Area-based control participants were sampled from the 2010 Census. Interviews assessed complete reproductive histories, including breastfeeding history (never, <6 months, and ≥6 months), PMCs experienced during pregnancy, self-reported race, and household financial struggles before age 13 years (to approximate childhood socioeconomic position (chSEP)). PMCs examined included: 1) premature birth, 2) diabetes or pre-diabetes related PMCs, 3) blood pressure-related PMCs, and 4) BMI ≥ 25 kg/m2 at age 18 years. Weighted percentages were evaluated with a chi-square test and considered significant at p < 0.05. Analyses were further stratified by race/ethnicity and chSEP. Result: NHB women were 2.4 times significantly more likely to never breastfeed than NHW women (W% =52.0 (NHB) and 21.3 (NHW), p=<0.0001). Similarly, women with lower compared to higher chSEP were 1.5 times significantly more likely to never breastfeed (W% = 42.7 (lower chSEP) and 28.5 (higher chSEP), p=0.003). Those with BMI ≥ 25 kg/m2 at age 18 years (p<0.001) alone, and with one or more PMCs (p=0.01) were also less likely to breastfeed. When stratified by race/ethnicity the pattern of breastfeeding did not differ significantly by any PMC within NHB and NHW women. When stratified by chSEP, however, BMI ≥ 25 kg/m2 at age 18 years (p = 0.004) and having one or more PMCs (p=0.03) were significantly associated with never breastfeeding among those with higher chSEP. Conclusion: NHB women and women with lower chSEP were substantially less likely to breastfeed. Additionally, BMI ≥ 25 kg/m2 at age 18 and PMCs were associated with lower frequency of breastfeeding overall and among those with higher chSEP. Citation Format: Meheret B. Gebreegziabher, Lydia R. Post, Chris C. Cho, Zhenzhen Zhang, Kelly A. Hirko, Dorothy R. Pathak, Ann S. Hamilton, Ann G. Schwartz, Ellen M. Velie. Racial and socioeconomic disparities in breast feeding and the impact of pregnancy-related medical conditions among a population-based sample of non-Hispanic Black and White women [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A014.

High arsenic contamination in the breast milk of mothers inhabiting the Gangetic plains of Bihar: a major health risk to infants

Groundwater arsenic poisoning has posed serious health hazards in the exposed population. The objective of the study is to evaluate the arsenic ingestion from breastmilk among pediatric population in Bihar. In the present study, the total women selected were n = 513. Out of which n = 378 women after consent provided their breastmilk for the study, n = 58 subjects were non-lactating but had some type of disease in them and n = 77 subjects denied for the breastmilk sample. Hence, they were selected for the women health study. In addition, urine samples from n = 184 infants’ urine were collected for human arsenic exposure study. The study reveals that the arsenic content in the exposed women (in 55%) was significantly high in the breast milk against the WHO permissible limit 0.64 µg/L followed by their urine and blood samples as biological marker. Moreover, the child’s urine also had arsenic content greater than the permissible limit (< 50 µg/L) in 67% of the studied children from the arsenic exposed regions. Concerningly, the rate at which arsenic is eliminated from an infant’s body via urine in real time was only 50%. This arsenic exposure to young infants has caused potential risks and future health implications. Moreover, the arsenic content was also very high in the analyzed staple food samples such as rice, wheat and potato which is the major cause for arsenic contamination in breastmilk. The study advocates for prompt action to address the issue and implement stringent legislative measures in order to mitigate and eradicate this pressing problem that has implications for future generations.

Adherence to Nutritional Practice Guideline in Premature Infants: A Nationwide Survey in Taiwan.

This study aimed to assess the current neonatal nutritional practices in Taiwan and promote consensus on standardized protocols. An online questionnaire comprising 95 items on parenteral nutrition (PN) and enteral nutrition (EN) practices was distributed to neonatal care units across Taiwan via email between August and December 2022. The responses were compared with the recommendations from the European Society for Pediatric Gastroenterology Hepatology and Nutrition for preterm infant care. Most of the 35 neonatal units, comprising 17 level III and 18 level II units, that participated in this study adhered to standard PN protocols; however, only 30% of units used protein-containing solutions as the initial fluid. Over half of the neonatal units provided calcium, phosphate, and magnesium at less than the recommended dosage. Trophic feeding commenced within 48 h in 88% of the units, with the mother's milk used as the first choice. All the units preferred commencing advanced feeding at <25 mL/kg/day. Most nutrient protocols for preterm infants in neonatal units in Taiwan meet recent guidelines, but discrepancies such as lower mineral supplements in PN and a slower advancement of enteral feeding increase nutritional risk. These issues warrant further research.