Missed Opportunities: The Cost of Suboptimal Breast Milk Feeding in the Neonatal Intensive Care Unit

Underwood, Mark A.

doi:10.1016/j.jpeds.2016.05.016

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…The relevance of these findings to clinical practice is still unclear given that there is no consensus about which is the most adequate intake of some vitamins, such as vitamin D or E, in preterm infants. Moreover, DHM is usually mature milk and does not guarantee appropriate vitamin coverage for preterm infants, for which it is often fortified [41,42].…”

Section: Discussionmentioning

confidence: 99%

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Escuder-Vieco¹,

Rodríguez

Espinosa-Martos³

et al. 2021

Life

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Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this study was to evaluate the effect of this HTST system on different nutrients and the bile salt stimulated lipase (BSSL) activity of DHM. DHM was processed in the HTST system and by standard HoP. Macronutrients were measured with a mid-infrared analyzer. Lactose, glucose, myo-inositol, vitamins and lipids were assayed using chromatographic techniques. BSSL activity was determined using a kit. The duration of HTST treatment had a greater influence on the nutrient composition of DHM than did the tested temperature. The lactose concentration and the percentage of phospholipids and PUFAs were higher in HTST-treated than in raw DHM, while the fat concentration and the percentage of monoacylglycerides and SFAs were lower. Other nutrients did not change after HTST processing. The retained BSSL activity was higher after short HTST treatment than that following HoP. Overall, HTST treatment resulted in better preservation of the nutritional quality of DHM than HoP because relevant thermosensitive components (phospholipids, PUFAs, and BSSL) were less affected.

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Section: Discussionmentioning

confidence: 99%

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Escuder-Vieco¹,

Rodríguez

Espinosa-Martos³

et al. 2021

Life

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“…Although the mechanism(s) by which breast milk improves the intestinal barrier is not known, it is likely to involve breast milk components such as the oligosaccharides that influence the intestinal microbiota, and other immunomodulatory factors such as lactoferrin and human milk peptides 39 . However, supplementing breast milk or preterm formula with a pre-biotic mixture of non-human milk neutral oligosaccharides did not improve intestinal barrier function compared with placebo in a randomized trial of infants <32 weeks, but supplementing preterm formula with the probiotic strain Bifidobacterium lactis improved barrier function at study day 30 40 .…”

Section: Discussionmentioning

confidence: 99%

Intestinal Barrier Maturation in Very Low Birthweight Infants: Relationship to Feeding and Antibiotic Exposure

Saleem

Okogbule-Wonodi

Fasano

et al. 2017

The Journal of Pediatrics

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Objective To test the hypothesis that feeding and antibiotic exposures affect intestinal barrier maturation in preterm infants, we serially measured intestinal permeability (IP) biomarkers in infants <33 wks gestation (GA) during the first two weeks of life. Study design Eligible infants <33 wks GA were enrolled within 4 days of birth in a prospective study of IP biomarkers (NCT01756040). Study participants received the non-metabolized sugars lactulose/rhamnose (La/Rh) enterally on study days 1, 8 and 15 and La/Rh were measured in urine by HPLC. Serum zonulin and fecal alpha-1 antitrypsin, two other IP markers, were measured by semi-quantitative western blot and ELISA, respectively. Results In a cohort of 43 subjects, the La/Rh ratio was elevated on day 1 and decreased over 2 weeks, but remained higher in infants ≤28 wk GA compared with IP in infants >28 wk GA. Exclusive breastmilk feeding was associated with more rapid maturation in intestinal barrier function. A cluster analysis of 35 subjects who had urine samples from all time points revealed three IP patterns (Cluster 1, normal maturation [N=20 (57%)]; Cluster 2, decreased IP during the first week and subsequent substantial increase [N=5 (14%)]; and Cluster 3, delayed maturation [N=10 (29%)]). There were trends towards more prolonged antibiotic exposure (p=0.092) and delayed initiation of feeding ≥4 days (p=0. 0.064) in infants with abnormal IP patterns. Conclusions Intestinal barrier maturation in preterm infants is GA and postnatal age-dependent and is influenced by feeding with a maturational effect of breastmilk feeding and may be by antibiotic exposures.

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“…Lactoferrin, one of the most important protein consumed by breast-fed infants immediately after birth, may be the major milk component responsible for decreasing infection, due to its antimicrobial, antioxidant, antifungal, anti-inflammatory, and immune-modulation properties. [7,8] Therefore, it is considered as a promising supplementation to promote the development of normal intestinal function and reduce the incidence of LOS and NEC in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Prophylactic lactoferrin for preventing late-onset sepsis and necrotizing enterocolitis in preterm infants

Cao

2018

Medicine

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Missed Opportunities: The Cost of Suboptimal Breast Milk Feeding in the Neonatal Intensive Care Unit

Cited by 7 publications

References 18 publications

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Intestinal Barrier Maturation in Very Low Birthweight Infants: Relationship to Feeding and Antibiotic Exposure

Prophylactic lactoferrin for preventing late-onset sepsis and necrotizing enterocolitis in preterm infants

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