scholarly journals Congenital Chylothorax in Preterm Infants – A New Approach in Dietary Treatment with Skimmed Breast Milk

2020 ◽  
Author(s):  
Michaela Höck ◽  
Alexander Höller ◽  
Marlene Hammerl ◽  
Karina Wechselberger ◽  
Jakob Krösslhuber ◽  
...  
Keyword(s):  
Breast Milk ◽  
Dietary Intervention ◽  
Medium Chain Triglyceride ◽  
Dietary Treatment ◽  
Favourable Outcome ◽  
University Hospital ◽  
Early Introduction ◽  
Congenital Chylothorax ◽  
Long Chain ◽  
Milk Feeding

Abstract BackgroundCongenital chylothorax (CC) is a rare but potentially life-threatening condition in newborns. It is defined as an accumulation of chyle in the pleural cavity. The few publications regarding medical management and therapeutic dietary intervention motivated us to share our experience.MethodsNeonates diagnosed with congenital chylothorax and treated at Innsbruck Medical University Hospital between 2013 and 2019 (n = 5, gestational age: 36 3/7, 32 5/7, 36 4/7, 35 0/7, 35 4/7) were eligible for this report. The cornerstones of treatment for chylothorax conventionally consist of chest tube drainage (CTD), respiratory support, dietary restriction of long-chain triglycerides (LCT) or total parenteral nutrition (TPN). In further course the introduction of a medium-chain triglyceride (MCT)-based formula followed by an overlapping switch to a formula with low LCT and high MCT, containing the essential long-chain fatty acids (LCFA), is attempted. As soon as possible, the change is made to breast milk feeding or breastfeeding. In two patients we used fat-modified (skimmed) breast milk to avoid discontinuation of breast milk feeding.ResultsThe early introduction of LCFA in the form of breast milk after resolution of chylothorax was associated with favourable outcome (no recurrence of pleural effusion and adequate weight gain).ConclusionThe first-line therapy of chylothorax is a combination of respiratory stabilization and dietary modification. The purpose of this report is to point out the feasibility of a fast change from LCT fat-free nutrition to full-fat nutrition once the chylothorax has dissolved, especially the early introduction of breast milk feeding / breastfeeding in infants with chylothorax.

scholarly journals Dietary treatment of congenital chylothorax with skimmed breast milk

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Michaela Höck ◽  
Alexander Höller ◽  
Marlene Hammerl ◽  
Karina Wechselberger ◽  
Jakob Krösslhuber ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Breast Milk ◽  
Dietary Intervention ◽  
Medium Chain Triglyceride ◽  
Favourable Outcome ◽  
University Hospital ◽  
Positive Effects ◽  
Congenital Chylothorax ◽  
Skimmed Milk ◽  
Long Chain

Abstract Background Congenital chylothorax (CC) is a rare but potentially life-threatening condition in newborns. It is defined as an accumulation of chyle in the pleural cavity. The few publications regarding medical management and therapeutic dietary intervention motivated us to share our experience. Methods Neonates diagnosed with congenital chylothorax and treated at Innsbruck Medical University Hospital between 2013 and 2020 (n = 6, gestational age: 36 3/7, 32 5/7, 36 4/7, 35 0/7, 35 4/7, 37 3/7 weeks) were eligible for this report. The cornerstones of treatment for chylothorax conventionally consist of chest tube drainage (CTD), respiratory support, dietary restriction of long-chain triglycerides (LCT) or total parenteral nutrition (TPN). In further course the introduction of a medium-chain triglyceride (MCT)-based formula followed by an overlapping switch to a formula with low LCT and high MCT, containing the essential long-chain fatty acids (LCFA), is attempted. In three patients we used fat-modified (skimmed) breast milk to provide a high protein and low fat diet and to avoid the discontinuation of breast milk. Results The outcome of an early introduction of LCFA in the form of skimmed breast milk after resolution of chylothorax diverse. One patient had a favourable outcome, meaning no recurrence of pleural effusion, adequate weight gain and a content mother, while another patient had a relapse of pleural effusion after the administration of skimmed milk and was therefore transitioned back to Basic F® . The CC of patient 5 was difficult due to Noonan syndrome. Two weeks after the introduction of skimmed breast milk the mother wanted to stop to express breast milk, so nutrition was changed to Basic F®. Conclusion The first-line therapy of chylothorax is a combination of respiratory stabilization and dietary modification. The use of skimmed breast milk is advisable in CC and feasible by means of a simple milk defatting procedure. It offers benefits to mothers who wish to resume breast feeding after resolution of chylothorax and has proven positive effects, above all in preterm infants as optimal nutrition with protective components superior to formula feeding. However, the nutritional analysis of the skimmed milk and the correlation to a re-accumulation of pleural fluid remains a question to be answered.

scholarly journals Maternal Outcomes of Breastfeeding in King Abdulaziz University Hospital, Saudi Arabia

2017 ◽  
Vol 24 (3) ◽  
pp. 29-38
Author(s):  
Lama A. Banjar ◽  
Hanan M. Faruqui ◽  
Afaf H. Ghunaim ◽  
Amal F. Almalki ◽  
Haifa M. Alshaikh ◽  
...  
Keyword(s):  
Weight Loss ◽  
Breast Milk ◽  
Postpartum Depression ◽  
Depression Scale ◽  
University Hospital ◽  
P Value ◽  
Anthropometric Measures ◽  
King Abdulaziz University ◽  
Postpartum Weight ◽  
Milk Feeding

Breastfeeding has a great efficacy on the growing infant, as well as the mother. It has been suggested that breastfeeding promotes postpartum weight loss. Furthermore, it may alter the risk of developing postpartum depression. The aim of this study is to further understand the adherence and the effect of breast milk feeding on developing a postpartum depression and calculating the postpartum weight reduction percentage in comparison to pre-pregnancy weight. A cross-sectional study was conducted in King Abdulaziz University Hospital among 153 mothers, whose infants are less than two years of age. Data were collected by interviewing the mothers using a standard questionnaire designed for the study and the HAMD depression scale with anthropometric measures. 85.62% of the study sample had breastfed, 43.38% breastfed for 1 to 2 months, and 24.18% for 6 months or more. However, the relationship of postpartum depression and breastfeeding was not significant with a P-value > 0.05. 84.97% of the included mothers had the same or greater weight than before pregnancy. In conclusion, mothers in King Abdulaziz University Hospital are well adherent to breast milk feeding. The association of breastfeeding to weight loss was not observed as suggested. Mothers with postpartum depression were less adherent to the practice of breastfeeding.

scholarly journals Maternal outcomes of breast milk feeding in King Abdulaziz University Hospital, Saudi Arabia

2015 ◽  
Author(s):  
L Banjar ◽  
A Ghunaim ◽  
H Alshaikh ◽  
H Faruqui ◽  
M Alsamti ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Breast Milk ◽  
University Hospital ◽  
Maternal Outcomes ◽  
King Abdulaziz University ◽  
Milk Feeding

DIETARY TREATMENT OF PROTEIN LOSS IN INTESTINAL LYMPHANGIECTASIA

PEDIATRICS ◽  
1964 ◽  
Vol 34 (5) ◽  
pp. 629-635
Author(s):  
Peter R. Holt
Keyword(s):  
Thoracic Duct ◽  
Marked Reduction ◽  
Medium Chain Triglyceride ◽  
Dietary Treatment ◽  
Intestinal Lymphangiectasia ◽  
Protein Loss ◽  
Lymphatic Flow ◽  
Formula Diet ◽  
Intestinal Protein ◽  
Long Chain

A 2-year-old child with exudative enteropathy due to intestinal lymphangiectasia and an associated congenital lymphangiomatous malformation of the arm is presented. Treatment with medium chain triglyceride formula diet resulted in marked reduction in intestinal protein losses and disappearance of all symptoms. It is suggested that the enhanced lymphatic flow resulting from the thoracic duct transport of absorbed long chain fat results in increased leakage of lymph into the gut in intestinal lymphangiectasia.

scholarly journals Long-chain saturated fatty acids in breast milk are associated with the pathogenesis of atopic dermatitis via induction of inflammatory ILC3s

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Weng Sheng Kong ◽  
Naohiro Tsuyama ◽  
Hiroko Inoue ◽  
Yun Guo ◽  
Sho Mokuda ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Atopic Dermatitis ◽  
Breast Milk ◽  
Saturated Fatty Acids ◽  
Lymphoid Cells ◽  
Interleukin 17 ◽  
Immune System Development ◽  
Molecular Patterns ◽  
Damage Associated Molecular Patterns ◽  
Long Chain

AbstractBreastfeeding influences the immune system development in infants and may even affect various immunological responses later in life. Breast milk provides a rich source of early nutrition for infant growth and development. However, the presence of certain compounds in breast milk, related to an unhealthy lifestyle or the diet of lactating mothers, may negatively impact infants. Based on a cohort study of atopic dermatitis (AD), we find the presence of damage-associated molecular patterns (DAMPs) activity in the mother’s milk. By non-targeted metabolomic analysis, we identify the long-chain saturated fatty acids (LCSFA) as a biomarker DAMPs (+) breast milk samples. Similarly, a mouse model in which breastfed offspring are fed milk high in LCSFA show AD onset later in life. We prove that LCSFA are a type of damage-associated molecular patterns, which initiate a series of inflammatory events in the gut involving type 3 innate lymphoid cells (ILC3s). A remarkable increase in inflammatory ILC3s is observed in the gut, and the migration of these ILC3s to the skin may be potential triggers of AD. Gene expression analysis of ILC3s isolated from the gut reveal upregulation of genes that increase ILC3s and chemokines/chemokine receptors, which may play a role in ILC migration to the skin. Even in the absence of adaptive immunity, Rag1 knockout mice fed a high-LCSFA milk diet develop eczema, accompanied by increased gut ILC3s. We also present that gut microbiota of AD-prone PA milk-fed mice is different from non-AD OA/ND milk-fed mice. Here, we propose that early exposure to LCSFAs in infants may affect the balance of intestinal innate immunity, inducing a highly inflammatory environment with the proliferation of ILC3s and production of interleukin-17 and interleukin-22, these factors may be potential triggers or worsening factors of AD.

scholarly journals Psychosocial stress and cortisol stress reactivity predict breast milk composition

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna Ziomkiewicz ◽  
Magdalena Babiszewska ◽  
Anna Apanasewicz ◽  
Magdalena Piosek ◽  
Patrycja Wychowaniec ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Breast Milk ◽  
Psychosocial Stress ◽  
Stress Reactivity ◽  
Unsaturated Fatty Acids ◽  
Fatty Acid Content ◽  
Milk Composition ◽  
Stressful Events ◽  
Psychological Status ◽  
Long Chain

AbstractWe studied a sample of 146 Polish, exclusively breastfeeding mothers and their healthy born on time infants to explore the effect of perinatal psychosocial stress on breast milk composition. Maternal perinatal stress was assessed using Recent Life Changes Questionnaire summarizing stressful events from the previous six months. Stress reactivity was determined by administering the cold pressor test and measuring cortisol in saliva samples taken during the test. Breast milk sample was taken to measure energy, protein, fat, lactose, and fatty acid content. Analyses revealed that stress reactivity was positively associated with milk fat and long-chain unsaturated fatty acids and negatively associated with milk lactose. Perinatal psychosocial stress negatively affected energy density, fat as well as medium-chain and long-chain saturated fatty acids in milk. These results, together with previous studies, advocate monitoring maternal psychological status during the peripartum to promote breastfeeding and healthy infant nutrition.

scholarly journals The enablers and barriers to continue breast milk feeding in women returning to work

2016 ◽  
Vol 72 (4) ◽  
pp. 825-835 ◽  
Author(s):  
Zaharah Sulaiman ◽  
Pranee Liamputtong ◽  
Lisa H. Amir
Keyword(s):  
Breast Milk ◽  
Returning To Work ◽  
Milk Feeding

Breast milk leukocytes

PEDIATRICS ◽  
1976 ◽  
Vol 58 (5) ◽  
pp. 769-770
Author(s):  
Jane Pitt
Keyword(s):  
Gastrointestinal Tract ◽  
Breast Milk ◽  
Human Milk ◽  
Apparent Increase ◽  
Human Colostrum ◽  
Available Information ◽  
Portal Of Entry ◽  
Milk Feeding

The apparent increase in frequency of neonatal necrotizing enterocolitis1 and the recognition that the gastrointestinal tract is often the portal of entry in neonatal sepsis2 has renewed interest in breast milk as a source of newborn immunity. Attention has recently focussed on milk leukocytes. The purpose of this commentary is to summarize the available information on this subject and to examine the implications that this knowledge may have on the possible use of human milk-feeding to protect the newborn from infection. Human colostrum and early milk contain 1 to 2 x 106 leukocytes; 80% to 90% of these are monocytic phagocytes and the remainder are lymphocytes.3,4

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