Donor Milk Research Articles

Nutrition of Newborns with Hypoxic-Ischaemic Encephalopathy during Therapeutic Hypothermia - A Survey of Practice in Polish Neonatal Care Units.

The nutritional practice for newborns with hypoxic-ischaemic encephalopathy during therapeutic hypothermia differs among Polish neonatal care units, as no guidelines are provided. We assessed the prevailing procedures. Data was collected through an anonymous, web-based questionnaire. We surveyed aspects of the current nutritional practices and the reasoning behind the choice of the feeding strategy. Thirty-one responses were obtained (31/33, 94%). Based on participants' estimations, 342 newborns are diagnosed with hypoxic-ischaemic encephalopathy and qualified for therapeutic hypothermia annually. Among them, almost ⅓ is fed exclusively parenterally, while 71% both ways-parenterally and enterally. In the vast majority of units, the introduction of enteral nutrition takes place during the first 48 hours of therapeutic hypothermia, and breast milk is primarily provided, although with substantial first feeding volume differentiation (an average of 2,9 ml/kg (0,3 - 10ml/kg)). Adverse events, such as necrotising enterocolitis, sepsis, and glycemia level disturbances that derive from the initiation of enteral nutrition, are difficult to estimate as no official statistics are provided. The majority of newborns after hypoxic-ischaemic encephalopathy treated with therapeutic hypothermia are fed both parenterally and enterally during the procedure, predominantly with expressed or donor breast milk. However, due to the lack of nutritional guidelines, significant variability of nutritional strategies concerning initiation time, type and volume of enteral feeds given is noted. Therefore, further studies are required to clarify feeding recommendations.

Does the Short-Lived First Human Milk Bank of Pakistan Hold Any Promise for the Future?

Does the Short-Lived First Human Milk Bank of Pakistan Hold Any Promise for the Future?

Acceptability to donate human milk among postnatal mothers at St. Francis hospital Nsambya, Uganda: a mixed method study

BackgroundThe World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).MethodsA cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach.ResultsOverall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years’ clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk.ConclusionsAcceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting.

Neurodevelopmental Outcomes of Extremely Preterm Infants Fed Donor Milk or Preterm Infant Formula

Maternal milk feeding of extremely preterm infants during the birth hospitalization has been associated with better neurodevelopmental outcomes compared with preterm formula. For infants receiving no or minimal maternal milk, it is unknown whether donor human milk conveys similar neurodevelopmental advantages vs preterm formula. To determine if nutrient-fortified, pasteurized donor human milk improves neurodevelopmental outcomes at 22 to 26 months' corrected age compared with preterm infant formula among extremely preterm infants who received minimal maternal milk. Double-blind, randomized clinical trial conducted at 15 US academic medical centers within the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants younger than 29 weeks 0 days' gestation or with a birth weight of less than 1000 g were enrolled between September 2012 and March 2019. Preterm formula or donor human milk feeding from randomization to 120 days of age, death, or hospital discharge. The primary outcome was the Bayley Scales of Infant and Toddler Development (BSID) cognitive score measured at 22 to 26 months' corrected age; a score of 54 (score range, 54-155; a score of ≥85 indicates no neurodevelopmental delay) was assigned to infants who died between randomization and 22 to 26 months' corrected age. The 24 secondary outcomes included BSID language and motor scores, in-hospital growth, necrotizing enterocolitis, and death. Of 1965 eligible infants, 483 were randomized (239 in the donor milk group and 244 in the preterm formula group); the median gestational age was 26 weeks (IQR, 25-27 weeks), the median birth weight was 840 g (IQR, 676-986 g), and 52% were female. The birthing parent's race was self-reported as Black for 52% (247/478), White for 43% (206/478), and other for 5% (25/478). There were 54 infants who died prior to follow-up; 88% (376/429) of survivors were assessed at 22 to 26 months' corrected age. The adjusted mean BSID cognitive score was 80.7 (SD, 17.4) for the donor milk group vs 81.1 (SD, 16.7) for the preterm formula group (adjusted mean difference, -0.77 [95% CI, -3.93 to 2.39], which was not significant); the adjusted mean BSID language and motor scores also did not differ. Mortality (death prior to follow-up) was 13% (29/231) in the donor milk group vs 11% (25/233) in the preterm formula group (adjusted risk difference, -1% [95% CI, -4% to 2%]). Necrotizing enterocolitis occurred in 4.2% of infants (10/239) in the donor milk group vs 9.0% of infants (22/244) in the preterm formula group (adjusted risk difference, -5% [95% CI, -9% to -2%]). Weight gain was slower in the donor milk group (22.3 g/kg/d [95% CI, 21.3 to 23.3 g/kg/d]) compared with the preterm formula group (24.6 g/kg/d [95% CI, 23.6 to 25.6 g/kg/d]). Among extremely preterm neonates fed minimal maternal milk, neurodevelopmental outcomes at 22 to 26 months' corrected age did not differ between infants fed donor milk or preterm formula. ClinicalTrials.gov Identifier: NCT01534481.

High hydrostatic pressure is similar to Holder pasteurization in preserving donor milk antimicrobial activity.

The microbiological safety of donor milk (DM) is commonly ensured by Holder pasteurization (HoP, 62.5 °C for 30 min) in human milk banks despite its detrimental effects on bioactive factors. We compared the antimicrobial properties of DM after Holder pasteurization treatment or High Hydrostatic Pressure processing (HHP, 350 MPa at 38 °C), a non-thermal substitute for DM sterilization. We assessed lactoferrin and lysozyme concentrations in raw, HHP- and HoP-treated pools of DM (n = 8). The impact of both treatments was evaluated on the growth of Escherichia coli and Group B Streptococcus in comparison with control media (n = 4). We also addressed the effect of storage of HHP treated DM over a 6-month period (n = 15). HHP milk demonstrated similar concentrations of lactoferrin compared with raw milk, while it was significantly decreased by HoP. Lysozyme concentrations remained stable regardless of the condition. Although a bacteriostatic effect was observed against Escherichia coli at early timepoints, a sharp bactericidal effect was observed against Group B Streptococcus. Unlike HoP, these results were significant for HHP compared to controls. Stored DM was well and safely preserved by HHP. Our study demonstrates that this alternative sterilization method shows promise for use with DM in human milk banks. Antimicrobial activity of donor milk after High Hydrostatic Pressure treatment has not been clearly evaluated. Donor milk lactoferrin is better preserved by High Hydrostatic Pressure than conventional Holder pasteurization, while lysozyme concentration is not affected by either treatment. As with Holder pasteurization, High Hydrostatic Pressure preserves donor milk bacteriostatic activity against E. coli in addition to bactericidal activity against Group B Streptococcus. Donor milk treated by High Hydrostatic Pressure can be stored safely for 6 months.

Dirasah Muqaranah ‘an Hukm al-Zawaj Bayna Rudha’a Alban Bunuk al-Laban Fi Manzhur Fuqaha al-Aqdamin wa al-Mu’ashirin

The issue of Breast Milk Bank is a contemporary fiqh issue, and its ruling is not found in classical fiqh. However, classical Moslem scholars have studied the issue of radha in an unusual way known as al-major (breast milk put into the baby's mouth), al-south (breast milk put through the nose), and or putting breast milk into the baby's mouth using bottles and cups. Therefore, the fuqaha differed on the prohibition of marriage because of radha' unusually or indirectly such as radha' from a breast milk bank. After conducting a comparative analysis, the author concludes that the majority of classical scholars from the Hanafi, Maliki, Shafi'i and Hambali madhhabs, and most contemporary fiqh scholars, think that indirect radha', such as radha' from a breast milk bank, makes marriage prohibited. They reason that indirect radha' has the same effect as direct radha' regarding the growth of the baby's flesh and bones. Meanwhile, the Zhahiri school of classical jurisprudence and some contemporary jurisprudence scholars such as Yusuf al-Qardhawi think that indirect radha' such as radha' from a breast milk bank is not called radha'. According to them, radha' is only if the baby suckles directly on the mother's nipple. Hence, they think that radha' from a breast milk bank does not lead to the prohibition of marriage.

A Cohort Study on Comparison of Volumes of Breast-Pump-Expressed Human Milk Donor Among Term and Preterm Gestational Mothers in South India––Time to Redefine “Coming to Volume” in the Milk Bank?

Introduction Human milk banking is an essential perinatal service. The present study evaluates the impact of gestational age on the volumes of milk. Further, it also re-evaluates the definition of “Coming to Volume” in pump-based expression of milk. Methodology This cohort study was conducted at a tertiary care centre in south India over 10 months from September 2022 to June 2023. The primary objective of the study was to compare the volume of donor milk secreted in relation to postnatal day among mothers delivered at term and preterm gestation. The secondary objective of the study was to compare the definition of “Coming to Volume” (secretion of 500 mL per day by postnatal day 14) with the volumes of milk in the present study. A surrogate marker for “Coming to Volume”, that is, an expression of at least 80 mL in one sitting of the donation was considered. Results Of the total 458 mothers, there were 349 (Term) and 109 (preterm) mothers. The average volumes of donor human milk were 142 mL and 122 mL among term and preterm mothers, respectively ( p-value .0068). Further, 80% of the term mothers and 75% of the preterm mothers were able to secrete>80 mL per sitting. This volume was attained by postnatal day 7 in 80% (223/280) of term mothers and 65% (53/82) of preterm mothers.

Human milk oligosaccharides promote intestinal epithelium regeneration independent of the microbiota during necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) is a severe intestinal disease primarily affecting premature infants, marked by impaired epithelial regeneration. Breastfed infants are less susceptible to NEC than formula-fed ones, and human milk oligosaccharides (HMO) found in breast milk have prebiotic properties that can protect against NEC. However, it is unclear how HMOs influence intestinal epithelium regeneration in relation to the gut microbiota. Broad-spectrum antibiotics were administered to pregnant dams to reduce the microbiota in offspring. NEC was induced through administration of hyperosmolar formula, lipopolysaccharide, and hypoxia from postnatal days (p) 5-9. Intestinal epithelial organoids were derived from p9 mice. HMOs were isolated from human donor breast milk and then solubilized in the formula for each feed or culture media for organoids. HMOs did not alter the microbiota profile in the presence of a normal or reduced microbiota. In the reduced microbiota, HMO treatment decreased NEC intestinal injury, and increased proliferation and stem cell activity. Additionally, in the complete absence of the microbiota, HMOs stimulated intestinal organoid growth. This study demonstrates that HMOs promoted intestinal epithelial regeneration independent of the gut microbiota. These findings provide further insight into the various benefits HMOs may have in the protection against NEC.

Setting up the first human milk bank in Uganda: a success story from Nsambya hospital.

The World Health Organization (WHO) strongly recommends the use of donor human milk (DHM) for low birth weight infants when mother's own milk is unavailable or insufficient. However, the use of DHM requires the availability of human milk banks (HMBs), the majority of which are in middle and high-income countries. Developing countries offer multiple opportunities and challenges regarding the establishment and operationalization of HMBs. This study describes the experience in setting up the HMB in Uganda at St. Francis Hospital Nsambya. The establishment of the first HMB in Uganda followed a step-wise approach using the PATH's Resource Toolkit for Establishing and Integrating Human Milk Banks. The steps included: performing a facility readiness assessment, implementing quality control measures, forming and training a committee for the Baby Friendly Hospital Initiative, establishing a monitoring and evaluation system, developing a communication strategy, engaging with the Ministry of Health, providing staff training by a Human Milk Bank consultant, and maintaining regular coordination by a dedicated technical team. A total of 170 donors have been screened and of these 140 have donated milk with a mean age of 26 years since the establishment of the bank in November 2021. A total of 108 admitted neonates have received the milk; majority (88%) are preterm infants with a mean gestational age of 34 weeks. A total of 90 liters have been collected and 76 distributed. The challenges in establishment of the Human Milk bank included: lack of guidelines on human milk banking, use of unpasteurized milk, lack of communication strategy, lack of clear model infrastructure and lactation training. We addressed the challenges: by drafting guidelines, set up a human milk bank and had training on use donor pasteurized milk, designed communication messages through videos and brochures, visited Pumwani hospital and remodeled the Human Milk Bank according to the model at Pumwani, all the health workers in the human milk bank had a training on Lactation. Assessing the experiences and attitudes of mothers, donors, healthcare providers, and hospital leaders revealed concerns about milk safety and fear about potential attachments or acquired traits through the donated milk to the babies that may receive it. Donors viewed milk donation as a life-saving act, although fears of breast cancer and lumps arose from misconceptions. To address these perspectives, creative media, such as videos and messages, were designed to raise awareness, promote behavioral change, and create demand for the HMB services. The establishment and integration of HMB services at hospitals in Uganda is feasible.

‘Human Milk Bank (HMB): The Journey till Now and the Road Ahead’: A Retrospective Observational Study in a Tertiary Care Centre of Western India

Background In the era of the 21st Century, Human Milk Bank (HMB) is making its tortoise steps towards revolution. The goals and objectives of this study is to compare five years of data between the Pre Human Milk Bank phase (2018–2021) and Post Human Milk Bank phase (2021–2023) in order to evaluate the morbidity and mortality profile of neonates fed with PDHM (pasteurized donor human milk) or MOM (Mother’s Own Milk). Methods A retrospective observational study was done in HMB, Neonatal Intensive Care Unit, Department of Paediatrics, Gmers Medical College, Gandhinagar, Gujarat. Data obtained retrospectively comparing pre-HMB Phase (4th August, 2018–3rd August, 2021) and post-HMB Phase (4th August, 2021–3rd August, 2023). Results Around 1822 newborns benefited from the establishment of the HMB and 2.89 lakh ml of milk from 188 donor mothers were gathered during the study. Bacterial contamination of PDHM was reduced. There was a reduction in mortality and morbidity profiles like sepsis rate, NEC/Feed intolerance and ROP. Duration of NICU stay was improved in all preterm babies. Conclusions In this study, mortality and morbidity outcomes improved and sepsis decreased after the establishment of the HMB with reduced time to reach full feeds and shorter hospital stay. It helps significantly in NEC cases. We concluded that the creation of an HMB will be more advantageous and useful for all preterm babies in order to achieve better results.

Milk microbiome transplantation: recolonizing donor milk with mother's own milk microbiota

Donor human milk (DHM) provides myriad nutritional and immunological benefits for preterm and low birthweight infants. However, pasteurization leaves DHM devoid of potentially beneficial milk microbiota. In the present study, we performed milk microbiome transplantation from freshly collected mother’s own milk (MOM) into pasteurized DHM. Small volumes of MOM (5%, 10%, or 30% v/v) were inoculated into pasteurized DHM and incubated at 37 °C for up to 8 h. Further, we compared microbiome recolonization in UV-C-treated and Holder-pasteurized DHM, as UV-C treatment has been shown to conserve important biochemical components of DHM that are lost during Holder pasteurization. Bacterial culture and viability-coupled metataxonomic sequencing were employed to assess the effectiveness of milk microbiome transplantation. Growth of transplanted MOM bacteria occurred rapidly in recolonized DHM samples; however, a greater level of growth was observed in Holder-pasteurized DHM compared to UV-C-treated DHM, potentially due to the conserved antimicrobial properties in UV-C-treated DHM. Viability-coupled metataxonomic analysis demonstrated similarity between recolonized DHM samples and fresh MOM samples, suggesting that the milk microbiome can be successfully transplanted into pasteurized DHM. These results highlight the potential of MOM microbiota transplantation to restore the microbial composition of UV-C-treated and Holder-pasteurized DHM and enhance the nutritional and immunological benefits of DHM for preterm and vulnerable infants.Key points• Mother’s own milk microbiome can be successfully transplanted into donor human milk.• Recolonization is equally successful in UV-C-treated and Holder-pasteurized milk.• Recolonization time should be restricted due to rapid bacterial growth.Graphical

Perception and Practices Related to Breast Milk Donation and Acceptance among Donor and Recipient’s Mothers of a Breast Milk Bank at a Tertiary Care Hospital in South India

Background: Human Milk Banks (HMB) ensure the availability of pasteurized donor breast milk for small forgestational age babies, low birth weight infants, sick new born and infants of mothers with failed lactation.Objectives: To assess the perception, practices and associated factors of breast milk donation and acceptanceamong donor and recipient’s mothers registered with the breast milk bank.Methodology: This hospital based cross-sectional study was conducted between July to September 2019 among70 donors and 70 beneficiaries who were mothers of children under 6 months of age, registered at the breast milkbank at a tertiary care hospital in Chennai. Data was collected by interview of the mothers with a predesignedsemi-structured questionnaire.Results: Only 74% of them were aware of breast milk bank services. Almost 47 (67.1%) had received more thantwice from breast milk bank. Proportion of recipient’s mothers who had complications during their delivery andproportion of children who were treated in NICU were significantly higher among the recipients (p < 0.001).Conclusion: Awareness on breast milk bank services is required especially among the mothers of prematurebabies, low birthweight neonates, and newborn receiving treatment in NICU.

Human Milk Banking: An Ounce of Liquid Gold to Save a Life

Human Milk Banking: An Ounce of Liquid Gold to Save a Life

Effect of human milk-based fortification in extremely preterm infants fed exclusively with breast milk: a randomised controlled trial

Mortality and severe morbidity remain high in extremely preterm infants. Human milk-based nutrient fortifiers may prevent serious complications and death. We aimed to investigate whether supplementation with human milk-based fortifier (HMBF), as compared to bovine milk-based fortifier (BMBF), reduced the incidence of the composite outcome of necrotising enterocolitis (NEC), sepsis, and mortality in extremely preterm infants exclusively fed human milk. In this multicentre, randomised controlled trial at 24 neonatal units in Sweden, extremely preterm infants born between gestational week 22+0 and 27+6 fed exclusively human breast milk (mother's own and/or donor milk), were randomly assigned (1:1) to receive targeted fortification with either HMBF or BMBF. Randomisation was conducted before the enteral feeds reached 100mL/kg/day, and was stratified by enrolment site, gestational age, singleton/twin, and sex. The allocation was concealed before inclusion, but after randomisation the study was not blinded for the clinical staff. For the NEC diagnosis, the study group was masked to an independent radiologist, and the final assessment of NEC and culture-proven sepsis was done by a blinded consensus panel review. The primary outcome was the composite of NEC stage II-III, culture-proven sepsis, and mortality from inclusion to discharge, no longer than postmenstrual week 44+0, in the intention-to-treat population (ClinicalTrials.gov, NCT03797157). Between February 21st, 2019, and May 21st, 2021, 229 neonates were randomly assigned (115 HMBF, 114 BMBF). After exclusion of one infant due to parents' withdrawal of consent, 228 infants were included in the intention-to-treat analysis. Of the 115 infants assigned to HMBF, 41 (35.7%) fulfilled the criteria of either NEC, sepsis, or death, compared with 39 (34.5%) of 113 infants assigned to BMBF (OR 1.05, 95% CI 0.61-1.81, p=0.86). Adverse events did not differ significantly between groups. Supplementation with HMBF, as compared with BMBF, did not reduce the incidence of the composite outcome of NEC, sepsis, or death. Our results do not support routine supplementation with HMBF as a nutritional strategy to prevent NEC, sepsis, or death in extremely preterm infants exclusively fed human milk. ALF grant, Prolacta Bioscience, Swedish Research Council, and Research Council for Southeast Sweden.

Suficiência de leite humano para prematuros em Unidades de Terapia Intensiva

Abstract Objective To analyze human milk sufficiency in Neonatal Intensive Care Units in the Metropolitan Region of São Paulo according to the number of premature babies, estimated demand for human milk and actual consumption. Methods This is a cross-sectional study, carried out at Human Milk Collection Stations and Human Milk Banks registered with the São Paulo Network of Human Milk Banks in 2017. Data from 2017 census vital statistics were used to identify premature baby distribution in Regional Health Care Networks. Results 100% of Human Milk Collection Stations and 84.6% of Human Milk Banks in São Paulo participated in the study. Pasteurized human milk distribution insufficiency was identified between estimated demand and actual consumption by premature babies. During the study period, only the Center and Southeast regions met 100% of human milk coverage, followed by the Greater ABC region, with 44.62%. Conclusion Most Human Milk Collection Stations and Human Milk Banks in the metropolitan region of São Paulo do not assist all premature children. The management of these units can contribute to encouraging donor recruitment and collected human milk optimization.

Effect of holder pasteurization and storage of donor human milk on Bacillus cereus survival

Abstract Introduction Human milk, which constitutes the best composed nutrition for infants, is not a sterile biofluid. Besides nutritional and bioactive components, many microorganisms have been found in human milk, including Bacillus cereus. Those pathogenic bacteria can be responsible for causing pneumonia or septicemia in neonates. Although Bacillus cereus infections are not common, they represent one of the increasing factors of a high mortality rate in the preterm infants group. Donor human milk (DHM) may be a significant source of this pathogen. Materials and Methods Given the high ability of Bacillus cereus spores to survive under different thermal conditions, we tested the effect of the holder pasteurization and storage points (4 °C and −21 °C) on sporulation and vegetative forms’ survival in inoculated human milk samples by culture method and light microscopy. Results Studies confirmed that holder pasteurization is effective against vegetative forms of Bacillus cereus. Additionally, during storage endospores were observed in all analyzed inoculated donor milk samples, both the pasteurized and unpasteurized samples, thus possibly promoting the occurrence of Bacillus cereus in DHM. Conclusions Bacillus cereus is considered a contamination in DHM and in the human milk banks’ (HMB) environment. There is a need to further develop methods of identifying, transmitting, and preventing bacteria forming spores, which could be applied in HMB.

Retrato das mães doadoras e variáveis associadas à doação de leite materno em um Banco de Leite Humano

ABSTRACT Objective To describe and analyze the donor mothers’ profile and variables associated with breast milk donation at Human Milk Bank in the municipality of Guarapuava, Paraná, Brazil. Methods This was a cross-sectional study obtained from information contained in the donor registration form between the period July 2013 (implementation of the service) to December 2019. The collected data were tabulated and descriptive analysis of variables and Chi-square and Fischer’s exact association tests were performed. Results Of 1,491 records analyzed, this research identified that 70.73% of donors were between 20 to 34 years old; 67.69% had prenatal care at public health network and 61.37% have had cesarean delivery. Most mothers (61.44%) remained as donor for 29 days and 53.83% of them donated up to 500 ml of milk. In addition, statistically significant association was observed between milk volume donated and donation time for the following variables: prenatal place care, gestational age, child's birth weight, child age, and smoking. Maternal age was associated with a higher volume of donated milk. Conclusion The study's findings reinforce the approaching importance the possibility of human milk donation during prenatal care, with emphasis on private health service, and throughout the women's and children's health care network, as well as on the community.

Nursing mothers' social representations regarding sexualities in the breastfeeding context: a correspondence factor analysis.

To analyze nursing mothers' social representations of sexuality in the breastfeeding context and their repercussions in sexual and reproductive health. An exploratory study grounded on the Theory of Social Representations and conducted in a Human Milk Bank from northern Brazil with 110 nursing mothers, following the Free Word Association Technique. Data were analyzed by means of Correspondence Factor Analysis in the software Tri- Deux-Mots 5.1. Sexual intercourse was the significant expression of sexualities, reflected in the representation of this phenomenon in breastfeeding, anchored in cultural gender relations; meanwhile, the search for sexual desire and pleasure connected to the ideal of romantic love arises. The bodily and daily changes inherent to this period take on an unfavorable connotation and become naturalized over time, negatively influencing nursing mothers' sexual and reproductive health. Understanding sexuality/sexualities in the breastfeeding context can support Nursing and Health care models in line with the social experiences and thoughts of the different groups of nursing mothers.

Perceptions of Mothers with Preterm Babies towards Donor Breast Milk at Women and Newborn Hospital,Lusaka Zambia

Perceptions of Mothers with Preterm Babies towards Donor Breast Milk at Women and Newborn Hospital,Lusaka Zambia

THE EFFECT OF A DIET ON THE OCCURRENCE OF OCHRATOXIN A IN BODY FLUIDS

Background. Ochratoxin A (OTA), a secondary metabolite of fungi, is produced by fungi of the As pergillus and Penicillium genera. It is supplied to the body with food consumed by people. The purpose of this study was to determine the occurrence of ochratoxin A in human body fluids in relation to diet. A part of the study group consisted of women who were donors from a breast milk bank. The aim of this study was to determine the correlation of ochratoxin A in body fluids (milk, urine, serum) and the diet of the women covered by the study. The study material consisted of 60 urine samples, 60 milk samples and 60 blood samples. Ochratoxin A in milk and urine was determined by HPLC with fluorescence detection. For the determination of ochratoxin A in blood serum, we used a liquid chromatography-mass spectrometer (LC - MS/MS) method. Results and conclusions. As a result of the analysis, it was found that as the frequency of consump tion of dried grape fruit increases, there is a significant increase in the level of OTA in breast milk. Next, it was shown that as the frequency of beer consumption increases, there is a significant increase in the level of OTA in maternal urine. Finally, it was shown that a significant increase in maternal serum OTA levels occurs with an increase in the frequency of consumption of dried fruit. OTA was found in 4 out of 60 milk samples, in 40 out of 60 urine samples and in 60 out of 60 serum samples. The surveyed women’s average age was 31 (ranging from 22 to 41). Given all the respondents, 46 lived in the city, 14 in rural areas, 35 were economically active, 22 were not, and 3 were on maternity leave. On average, they had 2 children (from 1 to 4). Of all children being fed, 35 were male and 25 female. On average, delivery occurred on the 37th week of pregnancy (between the 27th and 42nd week).