Breast Milk Banks: The New Model

PEDIATRICS ◽  
1977 ◽  
Vol 59 (1) ◽  
pp. 142-142
Author(s):  
Derrick B. Jelliffe ◽  
E. F. Patrice Jelliffe
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Necrotizing Enterocolitis ◽  
Bacterial Colonization ◽  
Protective Role ◽  
Present Evidence ◽  
New Model ◽  
Acute Necrotizing ◽  
Milk Banks

Present evidence seems to suggest increasingly that fresh human milk has a protective role in the syndrome of acute necrotizing enterocolitis. For this reason (and many others), there appears to be an understandable increase in interest in the development of breast-milk banks. Considerable information already exists concerning the organization of such banks in the early decades of the present century and prior to that time. However, the milk stored in such earlier banks was not usually fresh, as it was primarily required for feeding rather than for the control of bacterial colonization of the intestine.

scholarly journals The Impact of Maternal Breast Milk in Preventing Necrotizing Enterocolitis: A Narrative Review

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Siamak Afaghi ◽  
Fateme Sadat Rahimi ◽  
Farzad Esmaeili Tarki ◽  
Sahar Yazdani ◽  
Amirhossein Hosseini ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Growth Factor ◽  
Breast Milk ◽  
Human Milk ◽  
Necrotizing Enterocolitis ◽  
Transforming Growth Factor ◽  
Protective Role ◽  
Donor Human Milk ◽  
First Choice ◽  
The Impact

Context: Necrotizing enterocolitis (NEC), as a life-threatening gastrointestinal tract disease, is associated with high rates of morbidity and mortality. Extensive inflammation, progressive hemorrhagic necrosis, and overwhelming infection of the gut are reasons why NEC is known as a devastating disease in premature infants. Almost 45% of affected preterm infants die, and those who survive suffer from multiple complications. Human milk, the best food for newborns, plays a significant role in supporting the immune system. Both mother’s own milk (MOM) and donor human milk (DHM) are particularly important in the prevention and lessening of the severity of NEC. Evidence Acquisition: We searched PubMed, Elsevier, and Google Scholar databases for articles that investigated the correlation between NEC and human milk. Then all data were accessed about their relevancy to this current subject. Results: In summary, the purpose of this article is to firstly review the protective role of breast milk components against NEC, and secondly discussing the correlation between human milk and NEC in clinical studies. Human milk bio-components, including Lactoferrin, oligosaccharides, maternal soluble IgA, epidermal growth factor, transforming growth factor, prebiotic, probiotics, and antioxidants, have a protective effect against NEC. However, the importance of these components in donor human milk and the formula is underestimated. Conclusions: Human milk, as the first-choice of nutritional source, comprises a wide diversity of copious bio-components, which dwindle the risk and severity of NEC in many ways. The exact mechanisms are still unclear, the evidence strongly point out that human milk is superior to any other nutrition concerning protecting the gastrointestinal tract from NEC.

scholarly journals The Protective Influence of Chondroitin Sulfate, a Component of Human Milk, on Intestinal Bacterial Invasion and Translocation

2019 ◽  
Vol 35 (3) ◽  
pp. 538-549 ◽  
Author(s):  
Kathryn Y. Burge ◽  
Lindsey Hannah ◽  
Jeffrey V. Eckert ◽  
Aarthi Gunasekaran ◽  
Hala Chaaban
Keyword(s):  
Human Milk ◽  
Bacterial Infection ◽  
Cell Viability ◽  
Chondroitin Sulfate ◽  
Necrotizing Enterocolitis ◽  
Protective Role ◽  
Bacterial Invasion ◽  
Intestinal Inflammatory Disease ◽  
Vitro Model

Background:Human milk is known to be protective against necrotizing enterocolitis, a devastating intestinal inflammatory disease affecting the preterm population. Although the pathogenesis of necrotizing enterocolitis is yet to be solidified, intestinal integrity dysfunction, bacterial invasion and/or translocation, and inflammation may play important roles. Glycosaminoglycans, compounds naturally prevalent in both human milk and the intestine, are thought to be anti-inflammatory and capable of altering bacterial interactions within the gut.Research aim:In this study, we aimed to evaluate the potential of chondroitin sulfate, the most prominent class of glycosaminoglycans in human milk, to protect against bacterial infection in an intestinal in vitro model.Methods:T84 cell monolayers were treated with chondroitin sulfate and cell viability was assessed across a number of doses. Monolayers were then pretreated with chondroitin sulfate and subsequently challenged with E. coli invasion and translocation to evaluate any protective role of the compound against infection. Tight junction barrier function was assessed by transepithelial electrical resistance, and cytokine levels were evaluated.Results:Chondroitin sulfate at any dose up to 750 μg/ml was not associated with any statistically significant decrease in cell viability. Additionally, chondroitin sulfate at 750 μg/ml was associated with a 75% decrease in both bacterial invasion and translocation compared to control.Conclusions:These data suggest chondroitin sulfate may protect against bacterial infection through a reduction in both invasion and translocation, importantly without attendant reduction in cell viability.

scholarly journals Clinical Results of the Implementation of a Breast Milk Bank in Premature Infants (Under 37 Weeks) at the Hospital Universitario del Valle 2018–2020

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2187
Author(s):  
Javier Torres-Muñoz ◽  
Carlos Alberto Jimenez-Fernandez ◽  
Jennifer Murillo-Alvarado ◽  
Sofia Torres-Figueroa ◽  
Juan Pablo Castro
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Premature Infants ◽  
Odds Ratio ◽  
Neonatal Intensive Care ◽  
Clinical Results ◽  
Human Breast Milk ◽  
Milk Bank ◽  
Exploratory Data ◽  
Milk Banks

Breast milk is widely recognized as the best source of nutrition for both full term and premature babies. We aimed to identify clinical results of the implementation of a breast milk bank for premature infants under 37 weeks in a level III hospital. 722 neonates under 37 weeks, hospitalized in the Neonatal intensive care unit (ICU), who received human breast milk from the institution’s milk bank 57% (n = 412) vs. mixed or artificial 32% (n = 229), at day 7 of life. An exploratory data analysis was carried out. Measures of central tendency and dispersion were used, strength of association of odds ratio (OR) and its confidence intervals (95% confidence interval (CI)). 88.5% had already received human milk before day 7 of life. Those who received human milk, due to their clinical condition, had 4 times a greater chance of being intubated (OR 4.05; 95% CI 1.80–9.11). Starting before day 7 of life decreases the opportunity to develop necrotizing enterocolitis by 82% (adjusted odds ratio (ORa) 0.18; 95% CI 0.03–0.97), intraventricular hemorrhage by 85% (ORa 0.15; 95% CI 0.06–0.45) and sepsis by 77% (ORa 0.23; 95% CI 0.15–0.33). Receiving human milk reduces the probability of complications related to prematurity, evidencing the importance that breast milk banks play in clinical practice.

scholarly journals Free threonine in human breast milk is related to infant intestinal microbiota composition

Amino Acids ◽  
2021 ◽  
Author(s):  
Monika Riederer ◽  
Natascha Schweighofer ◽  
Slave Trajanoski ◽  
Claudia Stelzer ◽  
Miriam Zehentner ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Intestinal Microbiota ◽  
Serum Levels ◽  
Protective Role ◽  
Maternal Serum ◽  
Study Cohort ◽  
Human Breast Milk ◽  
Microbiota Composition ◽  
Correlation Analyses

Abstract Background Accumulating evidence indicates that free amino acids (FAA) might be bioactive compounds with potential immunomodulatory capabilities. However, the FAA composition in human milk is still poorly characterized with respect to its correlation to maternal serum levels and its physiological significance for the infant. Studies addressing the relation of human milk FAA to the infants' intestinal microbiota are still missing. Methods As part of a pilot study, maternal serum and breast milk FAA concentrations as well as infant intestinal microbiota (16S rRNA) were determined 2 months after birth. The study cohort consisted of 41 healthy mothers and their term delivered, healthy infants with normal birthweight. The relationship between maternal serum and milk FAA was determined by correlation analyses. Associations between (highly correlated) milk FAA and infant intestinal beta diversity were tested using PERMANOVA, LefSe and multivariate regression models adjusted for common confounders. Results Seven breast milk FAA correlated significantly with serum concentrations. One of these, threonine showed a negative association with abundance of members of the class Gammaproteobacteria (R2adj = 17.1%, p = 0.006; β= − 0.441). In addition, on the level of families and genera, threonine explained 23.2% of variation of the relative abundance of Enterobacteriaceae (R2adj; p = 0.001; β = − 0.504) and 11.1% of variability in the abundance of Escherichia/Shigella (R2adj, p = 0.025; β  = − 0.368), when adjusted for confounders. Conclusion Our study is the first to suggest potential interactions between breast milk FAA and infant gut microbiota composition during early lactation. The results might be indicative of a potential protective role of threonine against members of the Enterobacteriaceae family in breast-fed infants. Still, results are based on correlation analyses and larger cohorts are needed to support the findings and elucidate possible underlying mechanisms to assess the complex interplay between breast milk FAA and infant intestinal microbiota in detail.

scholarly journals Anti-Sars-Cov-2 IgA And IgG In Human Milk After Vaccination Is Dependent On Vaccine Type And Previous Sars-Cov-2 Exposure: A Longitudinal Study.

2021 ◽  
Author(s):  
Marta Selma-Royo ◽  
Christine Bauerl ◽  
Desiree Mena-Tudela ◽  
Laia Aguilar-Camprubi ◽  
Francisco Jose Perez-Cano ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Protective Role ◽  
Lactating Women ◽  
Time Points ◽  
Milk Samples ◽  
Vaccine Type ◽  
Vaccine Impact ◽  
Vectored Vaccine ◽  
The Impact

Importance: Limited data are available on COVID-19 vaccine impact in lactating women. Objective: To evaluate the impact of different COVID-19 vaccines on specific anti-SARS-CoV-2 IgA and IgG levels in human milk. Design, Settings and Participants: In this prospective observational study in Spain, 75 lactating women from priority groups receiving vaccination against SARS-CoV-2 were included (January to April 2021). Human milk samples were collected at seven-time points. A group with confirmed SARS-CoV-2 infection (n=19) and a group of women from prepandemic time (n=13) were included. Exposure: mRNA vaccines (BNT162b2 and mRNA-1273) and adenovirus-vectored vaccine (ChAdOx1 nCoV-19). Main Outcome(s) and Measure(s): Presence of IgA and IgG against RBD SARS-CoV-2 in breast milk. Results: Seventy-five vaccinated lactating women [mean age, 34.9±3.7 years] of whom 96% were Caucasic and 92% were health care workers. A total of 417 milk samples were included and vaccine distribution was BioNTech/Pfizer (BNT162b2, n=30), Moderna (mRNA-1273, n=21), and AstraZeneca (ChAdOx1 nCoV-19, n=24). For each vaccine, 7 time points were collected from baseline up to 25 days after the 1st dose and same points were collected for mRNA vaccines 30 days after 2nd dose. A strong reactivity was observed for IgG and IgA after vaccination mainly after the 2nd dose. Presence and the persistence of specific SARS-CoV-2 antibodies in breast milk were dependent on the vaccine-type and, on previous virus exposure. High inter-variability was observed, being relevant for IgA antibodies. IgG levels were significantly higher than those observed in milk from COVID-19 women while IgA levels were lower. Women with previous COVID-19 increased the IgG levels after the 1st dose to a similar level observed in vaccinated women after the 2nd dose. Conclusions and Relevance: Breast milk from vaccinated women contains anti-SARS-CoV-2 IgA and IgG, with highest after the 2nd dose. Levels were dependent on vaccine type and previous exposure to SARS-CoV-2. Previous COVID-19 influenced the vaccine effect after a single dose, which could be especially relevant in the design of vaccination protocols . Further studies are warranted to demonstrate the potential protective role of these antibodies against COVID-19 in infants from vaccinated and infected mothers through breastfeeding.

scholarly journals Human Milk Oligosaccharides: A Comprehensive Review towards Metabolomics

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 804
Author(s):  
Laura Corona ◽  
Anna Lussu ◽  
Alice Bosco ◽  
Roberta Pintus ◽  
Flaminia Cesare Marincola ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Genetic Factors ◽  
Environmental Influence ◽  
Protective Role ◽  
Point Of View ◽  
Human Milk Oligosaccharides ◽  
Milk Oligosaccharides ◽  
The Third

Human milk oligosaccharides (HMOs) are the third most represented component in breast milk. They serve not only as prebiotics but they exert a protective role against some significant neonatal pathologies such as necrotizing enterocolitis. Furthermore, they can program the immune system and consequently reduce allergies and autoimmune diseases’ incidence. HMOs also play a crucial role in brain development and in the gut barrier’s maturation. Moreover, the maternal genetic factors influencing different HMO patterns and their modulation by the interaction and the competition between active enzymes have been widely investigated in the literature, but there are few studies concerning the role of other factors such as maternal health, nutrition, and environmental influence. In this context, metabolomics, one of the newest “omics” sciences that provides a snapshot of the metabolites present in bio-fluids, such as breast milk, could be useful to investigate the HMO content in human milk. The authors performed a review, from 2012 to the beginning of 2021, concerning the application of metabolomics to investigate the HMOs, by using Pubmed, Researchgate and Scopus as source databases. Through this technology, it is possible to know in real-time whether a mother produces a specific oligosaccharide, keeping into consideration that there are other modifiable and unmodifiable factors that influence HMO production from a qualitative and a quantitative point of view. Although further studies are needed to provide clinical substantiation, in the future, thanks to metabolomics, this could be possible by using a dipstick and adding the eventual missing oligosaccharide to the breast milk or formula in order to give the best and the most personalized nutritional regimen for each newborn, adjusting to different necessities.

scholarly journals Views of Muslim mothers in Turkey on breast milk donation and human milk banks

2020 ◽  
Author(s):  
Berrak Mizrak Sahin
Keyword(s):  
Social Media ◽  
Breast Milk ◽  
Human Milk ◽  
High Resistance ◽  
Ethical Problem ◽  
Descriptive Study ◽  
University Hospital ◽  
Health Policies ◽  
Study Population ◽  
Milk Banks

Background & Aim: In many countries, human milk banks (HMBs) are included in children's health policies and regulations and are supported as an extension of national breastfeeding policies. Currently, there are no active HMBs in Turkey. This study aimed to evaluate the attitude, knowledge, and views of mothers about breast milk donation and HMBs. Methods & Materials: This descriptive study was conducted in a university hospital postnatal clinic in Eskişehir between January and April 2019. The study population comprised of 250 multipara mothers. Data were collected with the help of a questionnaire comprising three sections. Results: Only 28.4% of mothers knew about HMBs. A total of 40.8% of mothers indicated that they were against the establishment of HMBs in Turkey. However, only 61 mothers (24.4%) approved of obtaining milk from HMBs. Mothers who did not agree to the establishment of HMBs (77.5%) stated that babies who are fed with breast milk from the same mother would be milk siblings, and it would be an ethical problem if they got married to each other. Conclusion: Most mothers are hesitant to donate their milk to HMBs, mostly due to religious concerns. Even in a group of Turkish Muslim populations whose sociocultural level can be considered high, resistance against HMBs is thoughtful. It is essential to organize public campaigns, especially through social media, to raise awareness of HMBs. When the results of the study were taken into account, it is believed that an HMB model where the donors and recipients meet each other is necessary.

scholarly journals Human Milk Oligosaccharides to Prevent Gut Dysfunction and Necrotizing Enterocolitis in Preterm Neonates

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1461 ◽  
Author(s):  
Stine Bering
Keyword(s):  
Preterm Birth ◽  
Human Milk ◽  
Preterm Infants ◽  
Necrotizing Enterocolitis ◽  
Bacterial Colonization ◽  
Health Benefits ◽  
Preterm Neonates ◽  
Human Milk Oligosaccharides ◽  
High Concentration ◽  
Milk Oligosaccharides

This review focuses on the evidence for health benefits of human milk oligosaccharides (HMOs) for preterm infants to stimulate gut adaptation and reduce the incidence of necrotizing enterocolitis (NEC) in early life. The health benefits of breastfeeding are partly explained by the abundant HMOs that serve as prebiotics and immunomodulators. Gut immaturity in preterm infants leads to difficulties in tolerating enteral feeding and bacterial colonization and a high sensitivity to NEC, particularly when breast milk is insufficient. Due to the immaturity of the preterm infants, their response to HMOs could be different from that in term infants. The concentration of HMOs in human milk is highly variable and there is no evidence to support a specifically adapted high concentration in preterm milk. Further, the gut microbiota is not only different but also highly variable after preterm birth. Studies in pigs as models for preterm infants indicate that HMO supplementation to formula does not mature the gut or prevent NEC during the first weeks after preterm birth and the effects may depend on a certain stage of gut maturity. Supplemented HMOs may become more important for gut protection in the preterm infants when the gut has reached a more mature phase.

scholarly journals The Impact of Human Milk on Necrotizing Enterocolitis: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1322 ◽  
Author(s):  
Emma Altobelli ◽  
Paolo Matteo Angeletti ◽  
Alberto Verrotti ◽  
Reimondo Petrocelli
Keyword(s):  
Systematic Review ◽  
Human Milk ◽  
Risk Reduction ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Meta Analysis ◽  
Preterm Formula ◽  
The World ◽  
Milk Banks ◽  
The Impact

Background. Premature infants receiving breastfeed have a lower incidence of NEC than those fed preterm formula. This study aimed: (1) to update a systematic review and meta-analyses to evaluate the relationship between feeding and necrotizing enterocolitis (NEC) in low weight premature infants; (2) to conduct meta-regression analyses by subgroups; (3) to describe geographical distribution of milk banks in the world. Methods. Papers included in the meta-analysis were updated as of June 2019. Relative risks were used as a measure of effect size. Random effect models were used to account for different sources of variation among studies. For milk banks, the data reviewed by the literature were integrated with the information collected from countries’ institutional sites and milk bank networks. Results. Thirty-two papers were included in meta-analysis: six randomized controlled trials (RCTs) and 26 observational studies (OS). The census has found 572 milk banks around in the world. Brazil has the most active milk banks. RCTs meta-analysis indicates a risk reduction of NEC using human milk respect to formula: Relative risk (RR) = 0.62 (0.42–0.93). Seven OS compared quantities lower than human milk or higher than the 50th quantile showing a risk reduction of NEC:RR = 0.51 (0.31–0.85); 3 OS that evaluated human milk versus mixed feeding showing that human milk has a protective role on the development of NEC:RR = 0.74 (0.63–0.91). Results of subgroups analysis show that the risk reduction is statistically significant only for studies in which premature infants are given both their own and donated breastmilk. Conclusions. The possibility of preserving human milk and promoting donations guarantees an improvement in the health of newborns.

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