IntroductionKnowledge of the biology of human milk and the physiology of its production, secretion, and delivery is critical in deeply understanding the benefits of breastfeeding. Human breast milk is the optimal nutrition for infants because of its proven advantages for both the infant, and the mother. The World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the American College of Obstetricians and Gynecologists (ACOG) all recommend breastfeeding for the first six months of age [1]. Breastfeeding is exceptionally superior, giving mothers and infants distinct and substantial physical, mental, and developmental health advantages [2].Poor breast milk production is the most frequent cause of breastfeeding failure. Reduced breast milk production may occur in many conditions, such as pre-term birth, illness of the mother or child, mother-infant separation, anxiety and emotional stress. All these circumstances act as powerful inhibitors of breastfeeding. Milk production can be increased in several ways, such as; psychological support and relaxation techniques [1]. Nonetheless, many mothers seek guidance from their physicians by asking for medical products to increase their breast milk supply, and galactagogues are often highly recommended.Galactagogues are pharmaceutical agents, foods, or herbal supplements that are used to support the initiation, continuation, or augmentation of breast milk production [3]; hence they are often prescribed when a mother has an inadequate milk supply. Usually these prescribed galactagogues are artificially made drugs, which may contain substances that cause unpleasant side effects. For example, Metoclopramide (commercially known as Reglan®) is one of the most commonly prescribed drugs for increasing milk supply. However, its side

The objective of this study is to determine the growth parameters and nutritional biochemical markers and complications of fortification of human milk by post discharge formula of preterm very low birth weight newborns (VLBW). Fifty preterm infants less than 37 weeks with weight less than 1500 g were enrolled in the study. They received parental nutrition and feeding according to our protocol. When enteral feeding reached 100 cc/kg/day, infants were randomized into two groups: group I, Cases, n=25, where post discharge formula (PDF) was used for fortification, group II, Controls, n=25 with no fortification. Infants of both groups were given 50% of required enteral feeding as premature formula. This protocol was used until infants’ weight reached 1800 g. Daily weight, weekly length and head circumference were recorded. Hemoglobin, albumin (Alb), electrolytes, blood urea nitrogen (BUN) and clinical complications were documented. Human milk fortification with PDF resulted in better growth with increase in weight 16.8 and 13.78 g/kg/day (P=0.0430), length 0.76 and 0.58 cm/week (P=0.0027), and head circumference of 0.59 and 0.5 cm/week (P=0.0217) in cases and controls respectively. Duration of hospital stay was less in cases (22.76 versus 28.52 days in Controls), P=0.02. No significant changes were found in serum electrolytes, BUN, or Alb between both groups. Hemoglobin was significantly higher in Cases, P=0.04. There were no significant clinical complications. Our feeding protocol of fortification of human milk with PDF in preterm very low birth weight newborns resulted in better growth and decrease in length of hospital stay. The use of PDF could be an alternative option for fortification of mothers’ milk for preterm VLBW infants in developing countries with low resources.

Background: Aluminum phosphide (ALP) is a poisonous chemical used to fumigate stored grains. Despite its severe toxicity, there is no antidote and only supportive measures are used. Aluminum phosphide causes mitochondrial damage and oxidative stress. We want to clarify incidence of ALP-toxicity in Egypt and globally, its consequences on various organs, and therapy options. The medical community must be informed of the increased risk of ALPtoxicity and the additional consequences seen in new patients. We examined PubMed, Cochrane, and Scopus databases to search for all ALP-toxicity consequences and decide the bes t option to be taken in acute AIP-toxicity and its sequelae. Conclusion: The growing market availability of AIP makes it an easy option for self-harm or perhaps murder. Due to the absence of a precise antidote, affected people die quickly. It's important for the medical staff to be aware of the increasing danger of ALP-toxicity and the new complications observed in the new cases.