scholarly journals Point-of-care human milk testing for maternal secretor status

2021 ◽  
Author(s):  
Saeromi Chung ◽  
Lars Bode ◽  
Drew A. Hall
Keyword(s):  
Human Milk ◽  
Infant Health ◽  
Point Of Care ◽  
Unmet Need ◽  
Milk Composition ◽  
Sample Volume ◽  
Ulex Europaeus ◽  
Health And Development ◽  
Highly Correlated ◽  
High Degree

AbstractWe present an electrochemical impedimetric-based biosensor for monitoring the variation in human milk oligosaccharide (HMO) composition. 2′-Fucosyllactose (2’FL) is an HMO associated with infant growth, cognitive development, and protection from infectious diarrhea, one of the major causes of infant death worldwide. Due to genetic variation, the milk of some women (non-secretors) contains no or very little 2′FL with potential implications for infant health and development. However, there is currently no technology to analyze the presence and concentration of HMOs in human milk at the point-of-care (POC). The lack of such technology represents a major impediment to advancing human milk research and improving maternal-infant health. Towards this unmet need, we report an impedimetric assay for HMOs with an α-1,2 linkage, the most abundant of which is 2′FL. The sensor uses a lectin for affinity, specifically Ulex europaeusagglutininI (UEA), with electrochemical readout. In spiked studies, the sensor exhibited a high degree of linearity (R2 = 0.991) over 0.5 to 3.0 μM with a 330-nM detection limit. The sensor performance was clinically validated using banked human milk samples and correctly identified all secretor vs. non-secretor samples. Furthermore, despite the short 35-min assay time and low sample volume (25 μL), the assay was highly correlated with HPLC measurements. This bedside human milk testing assay enables POC, “sample-to-answer” quantitative HMO measurement, and will be a valuable tool to assess milk composition. Graphical abstract

scholarly journals Maternal and Perinatal Factors Associated with the Human Milk Microbiome

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Hans Demmelmair ◽  
Esther Jiménez ◽  
Maria Carmen Collado ◽  
Seppo Salminen ◽  
Michelle K McGuire
Keyword(s):  
Human Milk ◽  
Infant Health ◽  
Maternal Diet ◽  
Geographic Location ◽  
Milk Composition ◽  
Delivery Mode ◽  
Gi Tract ◽  
Perinatal Factors ◽  
Feeding Mode ◽  
Treatment And Prevention

ABSTRACT Microbes are present in human milk regardless of the mother's health. The origins of the milk microbiota likely include the mother's skin, infant's mouth, and transfer from the maternal gastrointestinal (GI) tract. Prominent bacterial taxa in human milk are Staphylococcus and Streptococcus, but many other genera are also found including anaerobic Lactobacillus, Bifidobacterium, and Bacteroides. The milk microbiome is highly variable and potentially influenced by geographic location, delivery mode, time postpartum, feeding mode, social networks, environment, maternal diet, and milk composition. Mastitis alters the milk microbiome, and the intake of Lactobacilli has shown potential for mastitis treatment and prevention. Although milk and infant fecal microbiomes are different, their variations appear to be related – suggesting that milk is an important contributor of early GI colonization. Nonetheless, nothing is known regarding whether the milk microbiome influences infant health. Further research and clinical interventions are needed to determine if changes in the microbiomes of human milk and infant formula/food impact health.

scholarly journals Endocannabinoid Metabolome Characterization of Transitional and Mature Human Milk

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1294 ◽  
Author(s):  
Adriana Gaitán ◽  
JodiAnne Wood ◽  
Fan Zhang ◽  
Alexandros Makriyannis ◽  
Carol Lammi-Keefe
Keyword(s):  
Human Milk ◽  
Infant Health ◽  
Cannabinoid Receptor ◽  
Bioactive Constituents ◽  
Mature Milk ◽  
Health And Development ◽  
Two Stages

Recognized as the gold standard, human milk (HM) is an extremely complex yet fascinating biofluid tailored to meet an infant’s nutritional requirements throughout development. Endocannabinoids and endocannabinoid-like compounds (endocannabinoid metabolome, ECM) are endogenous lipid mediators derived from long-chain polyunsaturated fatty acids that have been identified in HM. Previous research has shown that arachidonoylglycerol might play a role in establishing the infant’s suckling response during lactation by activating the type 1 cannabinoid receptor in the infant’s brain. The mechanisms of action and the role of the ECM in HM are not fully understood. Transitional and mature milk samples were collected from lactating women (n = 24) for ECM characterization, quantification, and to evaluate differences among the two stages. HM samples were analyzed by liquid chromatography-mass spectrometry. Identified members of the ECM were: arachidonoylethanolamine, palmitoylethanolamine, oleoylethanolamine, docosahexaenoylethanolamine, eicoapentaenoylethanolamine, eicosenoylethanolamine, arachidonoylglycerol, palmitoyglycerol, oleoylglycerol, docosahexaenoylglycerol, eicosapentaenoylglycerol, eiconenooylglycerol, arachidonic acid, docosahexaenoic acid, and eicosapentaenoic acid. Only docosahexaenoylglycerol was different across transitional and mature milk (p ≤ 0.05). Data from this cohort suggest that bioactive constituents in HM may also play a role in infant health and development. Future studies can be developed based on this study’s data to help elucidate specific roles for each ECM member in addition to understanding how the ECM modulates infant health.

Receiving Screened Donor Human Milk for Their Infant Supports Parental Wellbeing: a Mixed-methods Study

2021 ◽  
Author(s):  
Amy Brown ◽  
Natalie Shenker
Keyword(s):  
Mental Health ◽  
Human Milk ◽  
Infant Health ◽  
Positive Impact ◽  
Online Questionnaire ◽  
Donor Human Milk ◽  
Increased Risk ◽  
Health And Development ◽  
Almost All ◽  
The Impact

Abstract Background: Donor human milk (DHM) protects the health and development of premature infants but there has been little examination of the broader impact of an infant receiving it upon parental mental health. Breastfeeding and mental health are closely tied with women who experience breastfeeding difficulties or are unable to meet their own breastfeeding goals often experiencing feelings of guilt, sadness and anger, alongside an increased risk of postnatal depression. The aim of the current study was to explore how experience of receiving DHM for their baby affected the wellbeing of parents.Methods: UK parents of infants aged 0 – 12 months who had received screened DHM from a milk bank (typically on the neonatal unit or in some cases in the community) completed an online questionnaire exploring their experiences. The questionnaire included Likert scale items examining perceived impact upon infant health, own wellbeing and family functioning alongside open-ended questions exploring perceptions of how receiving DHM affected wellbeing.Results: Almost all of the 107 participants (women=102) agreed that receiving DHM had a positive impact upon infant health and development, their own mental and physical health, and their family’s wellbeing. Parents felt relieved that their infant was receiving DHM for health reasons but also due to the experience of being listened to, supported and having their infant feeding decisions facilitated. Receiving DHM helped mothers to process some of their emotions at not being able to breastfeed, in part because knowing their baby was being fed gave them the space to focus on recovery and bonding with their baby. Some parents did experience challenges, feeling guilty at receiving DHM, insecure that another woman was able to feed their baby when they could not, with some negative reactions from family. Although the impact of receiving DHM upon breastfeeding was not measured, some women who were working to build their own milk supply noted that it helped motivate them to continue.Conclusions: DHM may play an important role not only in protecting infant health and development but in supporting the mental health and wellbeing of mothers for whom their infant receiving human milk is important.

scholarly journals NIH workshop on human milk composition: summary and visions

2019 ◽  
Vol 110 (3) ◽  
pp. 769-779 ◽  
Author(s):  
Kellie O Casavale ◽  
Jaspreet K C Ahuja ◽  
Xianli Wu ◽  
Ying Li ◽  
Julia Quam ◽  
...  
Keyword(s):  
Human Milk ◽  
Infant Health ◽  
Kidney Diseases ◽  
The United States ◽  
Milk Composition ◽  
Consumer Information ◽  
Data Repository ◽  
Missed Opportunities ◽  
Factors Affecting ◽  
Methodological Considerations

ABSTRACT Nationally representative data from mother–child dyads that capture human milk composition (HMC) and associated health outcomes are important for advancing the evidence to inform federal nutrition and related health programs, policies, and consumer information across the governments in the United States and Canada as well as in nongovernment sectors. In response to identified gaps in knowledge, the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH sponsored the “Workshop on Human Milk Composition—Biological, Environmental, Nutritional, and Methodological Considerations” held 16–17 November 2017 in Bethesda, Maryland. Through presentations and discussions, the workshop aimed to 1) share knowledge on the scientific need for data on HMC; 2) explore the current understanding of factors affecting HMC; 3) identify methodological challenges in human milk (HM) collection, storage, and analysis; and 4) develop a vision for a research program to develop an HMC data repository and database. The 4 workshop sessions included 1) perspectives from both federal agencies and nonfederal academic experts, articulating scientific needs for data on HMC that could lead to new research findings and programmatic advances to support public health; 2) information about the factors that influence lactation and/or HMC; 3) considerations for data quality, including addressing sampling strategies and the complexities in standardizing collection, storage, and analyses of HM; and 4) insights on how existing research programs and databases can inform potential visions for HMC initiatives. The general consensus from the workshop is that the limited scope of HM research initiatives has led to a lack of robust estimates of the composition and volume of HM consumed and, consequently, missed opportunities to improve maternal and infant health.

scholarly journals Sex-Specific Human Milk Composition: The Role of Infant Sex in Determining Early Life Nutrition

Nutrients ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 1194 ◽  
Author(s):  
Laura Galante ◽  
Amber Milan ◽  
Clare Reynolds ◽  
David Cameron-Smith ◽  
Mark Vickers ◽  
...  
Keyword(s):  
Human Milk ◽  
Early Life ◽  
Infant Health ◽  
Energy Content ◽  
Compositional Analysis ◽  
Milk Composition ◽  
Experimental Models ◽  
Current Data ◽  
Perinatal Complications ◽  
Animal Milk

Male and female infants respond differentially to environmental stimuli, with different growth and neurodevelopmental trajectories. Male infants are more likely to be disadvantaged when subjected to adversity and show a higher risk of perinatal complications. However, the underlying causes of this sex-bias are not well defined and optimising the early life nutritional care may be necessary to minimise the “male disadvantage” that may be experienced early in life. Experimental models have demonstrated that animal milk composition differs according to offspring sex, suggesting that the tailoring of early life nutrition may be one mechanism to maximise health protection and development to infants of both sexes. However, evidence for a sex-specificity in human milk composition is limited and conflicting, with studies documenting higher milk energy content for either male or female infants. These data show sex differences, however, there has been limited compositional analysis of the current data nor strategies proposed for how sex-specific compositional differences in early life nutrition may be used to improve infant health. The present narrative review highlights that an improved understanding of sex-specific human milk composition is essential for promoting optimal infant growth and development.

scholarly journals Elucidating Human Milk Oligosaccharide biosynthetic genes through network-based multiomics integration

2020 ◽  
Author(s):  
Benjamin P. Kellman ◽  
Anne Richelle ◽  
Jeong-Yeh Yang ◽  
Digantkumar Chapla ◽  
Austin W. T. Chiang ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Human Milk ◽  
Molecular Basis ◽  
Infant Health ◽  
Rna Expression ◽  
Expression Data ◽  
Human Milk Oligosaccharides ◽  
Kinetic Assay ◽  
Health And Development ◽  
Human Milk Oligosaccharide

AbstractHuman Milk Oligosaccharides (HMOs) are abundant carbohydrates fundamental to infant health and development. Although these oligosaccharides were discovered more than half a century ago, their biosynthesis in the mammary gland remains largely uncharacterized. Here, we used a systems biology framework that integrated glycan and RNA expression data to construct an HMO biosynthetic network and predict glycosyltransferases involved. To accomplish this, we constructed models describing the most likely pathways for the synthesis of the oligosaccharides accounting for >95% of the HMO content in human milk. Through our models, we propose candidate genes for elongation, branching, fucosylation, and sialylation of HMOs. We further explored selected enzyme activities through kinetic assay and their co-regulation through transcription factor analysis. These results provide the molecular basis of HMO biosynthesis necessary to guide progress in HMO research and application with the ultimate goal of understanding and improving infant health and development.Significance statementWith the HMO biosynthesis network resolved, we can begin to connect genotypes with milk types and thereby connect clinical infant, child and even adult outcomes to specific HMOs and HMO modifications. Knowledge of these pathways can simplify the work of synthetic reproduction of these HMOs providing a roadmap for improving infant, child, and overall human health with the specific application of a newly limitless source of nutraceuticals for infants and people of all ages.

scholarly journals The Determinants of the Human Milk Metabolome and Its Role in Infant Health

Metabolites ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 77 ◽  
Author(s):  
Anna Ojo-Okunola ◽  
Stefano Cacciatore ◽  
Mark P. Nicol ◽  
Elloise du Toit
Keyword(s):  
Human Milk ◽  
Infant Health ◽  
Optimal Growth ◽  
Immunodeficiency Virus ◽  
Health And Development ◽  
Established Relationship ◽  
Functional Components ◽  
Insight Into ◽  
Immature Immune System

Human milk is needed for optimal growth as it satisfies both the nutritional and biological needs of an infant. The established relationship between breastfeeding and an infant’s health is attributable to the nutritional and non-nutritional, functional components of human milk including metabolites such as the lipids, amino acids, biogenic amines and carbohydrates. These components have diverse roles, including protecting the infant against infections and guiding the development of the infant’s immature immune system. In this review, we provide an in-depth and updated insight into the immune modulatory and anti-infective role of human milk metabolites and their effects on infant health and development. We also review the literature on potential determinants of the human milk metabolome, including maternal infectious diseases such as human immunodeficiency virus and mastitis.

Comparison of 2 glucose analytical methodologies in immature Kemp’s ridley sea turtles: dry chemistry of plasma versus point-of-care glucometer analysis of whole blood

2021 ◽  
pp. 104063872110018
Author(s):  
Justin R. Perrault ◽  
Michael D. Arendt ◽  
Jeffrey A. Schwenter ◽  
Julia L. Byrd ◽  
Kathryn A. Tuxbury ◽  
...  
Keyword(s):  
Whole Blood ◽  
Point Of Care ◽  
Sea Turtles ◽  
Sample Volume ◽  
Specific Reference ◽  
Volume Data ◽  
Analytical Methodology ◽  
Glucose Determination ◽  
Kemp's Ridley Sea Turtles ◽  
Kemp's Ridley

Blood glucose measurements provide important diagnostic information regarding stress, disease, and nutritional status. Glucose analytical methodologies include dry chemistry analysis (DCA) of plasma and point-of-care (POC) glucometer analysis of whole blood; however, these 2 methods differ in cost, required sample volume, and processing time. Because POC glucometers use built-in equations based on features of mammalian blood to convert whole blood measurements to plasma equivalent units, obtained glucose data must be compared and validated using gold-standard chemistry analytical methodology in reptiles. For in-water, trawl-captured, immature Kemp’s ridley sea turtles ( Lepidochelys kempii) from Georgia, USA, we observed significant, positive agreement between the 2 glucose determination methods; however, the glucometer overestimated glucose concentrations by 1.4 mmol/L on average in comparison to DCA and produced a wider range of results. The discordance of these results suggests that POC glucometer glucose data should be interpreted in the context of methodology- and brand-specific reference intervals along with concurrent packed cell volume data.

scholarly journals Early Detection of Diabetic Peripheral Neuropathy: A Focus on Small Nerve Fibres

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 165
Author(s):  
Jamie Burgess ◽  
Bernhard Frank ◽  
Andrew Marshall ◽  
Rashaad S. Khalil ◽  
Georgios Ponirakis ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Nerve Fibre ◽  
Diabetic Peripheral Neuropathy ◽  
Point Of Care ◽  
Unmet Need ◽  
Screening Tools ◽  
Nerve Fibres ◽  
Diagnostic Laboratory ◽  
Corneal Confocal Microscopy ◽  
Small Nerve

Diabetic peripheral neuropathy (DPN) is the most common complication of both type 1 and 2 diabetes. As a result, neuropathic pain, diabetic foot ulcers and lower-limb amputations impact drastically on quality of life, contributing to the individual, societal, financial and healthcare burden of diabetes. DPN is diagnosed at a late, often pre-ulcerative stage due to a lack of early systematic screening and the endorsement of monofilament testing which identifies advanced neuropathy only. Compared to the success of the diabetic eye and kidney screening programmes there is clearly an unmet need for an objective reliable biomarker for the detection of early DPN. This article critically appraises research and clinical methods for the diagnosis or screening of early DPN. In brief, functional measures are subjective and are difficult to implement due to technical complexity. Moreover, skin biopsy is invasive, expensive and lacks diagnostic laboratory capacity. Indeed, point-of-care nerve conduction tests are convenient and easy to implement however questions are raised regarding their suitability for use in screening due to the lack of small nerve fibre evaluation. Corneal confocal microscopy (CCM) is a rapid, non-invasive, and reproducible technique to quantify small nerve fibre damage and repair which can be conducted alongside retinopathy screening. CCM identifies early sub-clinical DPN, predicts the development and allows staging of DPN severity. Automated quantification of CCM with AI has enabled enhanced unbiased quantification of small nerve fibres and potentially early diagnosis of DPN. Improved screening tools will prevent and reduce the burden of foot ulceration and amputations with the primary aim of reducing the prevalence of this common microvascular complication.

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