About nitrogen metabolism with a lacto-vegetable diet

In one of our reports, we were able to show that a milk diet, which does not satisfy the energy needs of scarlet fever patients, leads to a negative nitrogen balance. Since in the milk diet, along with a moderate content of protein and fat, there were extremely few carbohydrates, it was natural to assume that an increase in the amount of the latter could have a significant effect on protein metabolism. To replenish food with carbohydrates, we included in the diet, in addition to milk, vegetable purees, cereals, jelly. The menu was composed in such a way that for breakfast and dinner, patients were given porridge with milk, and for lunch, vegetable puree and cranberry jelly. In addition, children received 200 grams twice a day. milk as a drink. The well-known schematization of dishes was carried out in order to facilitate the technical conditions of work. According to a preliminary calculation, the total caloric value of our lacto-vegetable diet was 2086 calories, with a content of 56 grams in food. squirrel, 294 gr. carbohydrates and 70 gr. fat. Of the 10 children put on this menu, only one 12-year-old patient with a mild form of scarlet fever ate the whole food offered to him, while the rest of the children were content with more or less of the dishes they were given. Patients aged 4-5 years drank an average of 600-700 grams. milk and ate 150-300 gr. porridge, 75-150 gr. mashed potatoes and 150-200 gr. jelly; older children ate 400-500 grams. porridge, 150-300 gr. puree, 250-300 gr. jelly and about 800 gr. milk.

Milk Formula Diet Alters Bacterial and Host Protein Profile in Comparison to Human Milk Diet in Neonatal Piglet Model

The metaproteome profiling of cecal contents collected from neonatal piglets fed pasteurized human milk (HM) or a dairy-based infant formula (MF) from postnatal day (PND) 2 to 21 were assessed. At PND 21, a subset of piglets from each group (n = 11/group) were euthanized, and cecal contents were collected for further metaproteome analysis. Cecal microbiota composition showed predominantly more Firmicutes phyla and Lachnospiraceae family in the lumen of cecum of HM-fed piglets in comparison to the MF-fed group. Ruminococcus gnavus was the most abundant species from the Firmicutes phyla in the cecal contents of the HM-fed piglets at 21 days of age. A greater number of expressed proteins were identified in the cecal contents of the HM-fed piglets relative to the MF-fed piglets. Greater abundances of proteins potentially expressed by Bacteroides spp. such as glycoside enzymes were noted in the cecal lumen of HM-fed piglets relative to the MF. Additionally, lyases associated with Lachnospiraceae family were abundant in the cecum of the HM group relative to the MF group. Overall, our findings indicate that neonatal diet impacts the gut bacterial taxa and microbial proteins prior to weaning. The metaproteomics data were deposited into PRIDE, PXD025432 and 10.6019/PXD025432.

Effects of an exclusive human-milk diet in preterm neonates on early vascular aging risk factors (NEOVASC): study protocol for a multicentric, prospective, randomized, controlled, open, and parallel group clinical trial

Background Preterm birth accounts for approximately 11% of all livebirths globally. Due to improvements in perinatal care, more than 95% of these infants now survive into adulthood. Research has indicated a robust association between prematurity and increased cardiovascular risk factors and cardiovascular mortality. While the innate adverse effects of prematurity on these outcomes have been demonstrated, therapeutic strategies on the mitigation of these concerning developments are lacking. The primary objective of the NEOVASC clinical trial is therefore to investigate whether the administration of a prolonged exclusive human-milk diet in preterm infants is capable of alleviating the harmful effects of preterm birth on the early development of cardiovascular risk factors. Methods The NEOVASC study is a multicentric, prospective, randomized, controlled, open, and parallel group clinical trial conducted in four Austrian tertiary neonatal care facilities. The purpose of the present trial is to investigate the effects of a prolonged exclusive human-milk-diet devoid of bovine-milk-based food components on cardiovascular and metabolic risk factors at 1, 2, and 5 years of corrected age. Primary outcomes include assessments of fasting blood glucose levels, blood pressure levels, and the distensibility of the descending aorta using validated echocardiographic protocols at 5 years of corrected age. The test group, which consists of 200 preterm infants, will therefore be compared to a control group of 100 term-born infants and a historical control group recruited previously. Discussion Given the emerging implications of an increased cardiovascular risk profile in the potentially growing population of preterm infants, further research on the mitigation of long-term morbidities in formerly preterm infants is urgently warranted. Further optimizing preterm infants’ nutrition by removing bovine-milk-based food components may therefore be an interesting approach worth pursuing. Trial registration ClinicalTrials.govNCT04413994. Registered on 4 June 2020.

Growth outcomes of small for gestational age preterm infants before and after implementation of an exclusive human milk-based diet

Objective Small for gestational age (SGA) preterm infants (PT) are at greatest risk for growth failure. Our objective was to assess the impact of an exclusive human milk diet (HUM) on growth velocities and neonatal morbidities from birth to discharge in a SGA population. Study design Multicenter, retrospective cohort study, subgroup analysis of SGA PT comparing a cow’s milk diet (CMD) with HUM diet. Results At birth 420 PT were classified as SGA (197 CMD group, 223 HUM group). Demographics and anthropometric measurements were similar. HUM group PT showed improvement in length Z score at discharge (p = 0.024) and reduction in necrotizing enterocolitis (NEC) (p = 0.004). Conclusion SGA PT fed a HUM diet had significantly decreased incidence of NEC, surgical NEC, and late-onset sepsis. Due to concerns about growth in a HUM diet, it is reassuring SGA infants fed the HUM diet had similar growth to CMD diet with trends toward improvement.

100% human milk diet: an integral part of nutrition management in NICU: PAN India neonatologist’s survey

Background: Exclusive human milk diet (EHMD) benefits preterm infants the most, particularly in neonatal intensive care unit. EHMD is dependent on multiple factors consisting of breastfeeding awareness, availability of pasteurized donor human milk, functioning human milk banks and infrastructure. Neonatal nutritional practice varies considerably in India. The aim of this survey was to understand the implementation and benefits of 100% human milk diet through human milk derived nutritional products in preterm infants from NICU experts’ perspective.Methods: The online survey questionnaire formulated and reviewed by the expert neonatologists was shared with the NICU experts pan India through multiple communication channels and referrals. The survey was constructed on the Google Forms platform, the responses was collected between May 2020 to July 2020.Results: A total of 100 neonatologists responded to the survey from 79 hospitals and 31 cities across India. All the respondents (100%) opined that EHMD is important for preterm infants, 15% opined that EHMD was ensured to all preterm infants, 80% opined that human milk-based fortifier (HMBF) was safe and well tolerated by premature infants, 17% reported that 51-80% of preterm infants experience feed intolerance issues with bovine milk based fortifiers (BMBF), blood urea nitrogen (49%) was chosen as an optimal biochemical parameter for assessing protein utilization in NICU, 93% opined that post discharge nutritional supplementation is required for preterm infants among which 49% respondents opined that HMBF and human milk 70 calorie sachet would be preferable as post discharge nutritional supplementation.Conclusions: EHMD unequivocally offers multiple benefits to preterm infants and hence needs to be included in the NICU protocol, availability of human milk derived nutritional products such as HMBF are termed safe and well tolerated and would aid in implementing EHMD in NICUs. Pasteurized donor human milk is vital for ensuring EHMD, thus access to the same needs to be empowered by strengthening the human milk donation and awareness measures.