Maternal Transmission of SARS-CoV-2: Safety of Breastfeeding in Infants Born to Infected Mothers

Coronavirus disease 2019 (COVID-19) is a recent epidemic disease caused by severe acute respiratory syndrome virus type 2 (SARS-CoV-2). In pregnancy, SARS-Cov-2 infection creates additional alarm due to concerns regarding the potential for transmission from the mother to the baby during both the antenatal and postpartum times. In general, breastfeeding is seldom disallowed because of infection of the mother. However, there are few exceptions with regards to certain infectious organisms with established transmission evidence from mother to infant and the link of infection of a newborn with significant morbidity and mortality. It is confirmed that pregnant women can become infected with SARS-CoV-2, although the debate on the possible vertical transmission of SARS-CoV-2 infection during pregnancy is still open. In this regard, the literature is still poor. On the contrary, the information on the safety of breastfeeding even during infections seems reassuring when the mother takes the necessary precautions. However, there are still answered questions regarding the precautions to be taken during breastfeeding by COVID-19 patients. This paper reviews the existing answers to these and many other questions. This review therefore presents a summary of the present-day understanding of infection with SARS-CoV-2 and discusses the answers around the maternal transmission of COVID-19 and the potential threat of breastfeeding to babies born to infected pregnant mothers. In conclusion, intrauterine transmission of SARS-CoV-2 infection is less likely to occur during pregnancy. Most studies suggest that COVID-19 is not transmitted through breast milk. Correspondingly, COVID-19-infected neonates might acquire the infection via the respiratory route because of the postnatal contact with the mother rather than during the prenatal period. International organizations encourage breastfeeding regardless of the COVID-19 status of the mother or child as long as proper hygienic and safety measures are adhered to so as to minimize the chance of infant infection by droplets and direct contact with the infected mother. Pasteurized donor human milk or infant formula as supplemental feeding can be quite beneficial in the case of mother–infant separation till breastfeeding is safe.

P-P24 Optimising post-operative nutrition in patients undergoing pancreaticoduodenectomy

Background A considerable number of patients undergoing pancreaticoduodenectomy require supplemental nutrition in the postoperative period. However, there remains no national consensus on the optimal postoperative supplemental feeding modality. Furthermore, at our institution a variation in practice exists when considering post-operative entera (via the naso-jejunal (NJ)) or parenteral nutrition (PN). This study aimed to evaluate the utility of post-operative enteral or parenteral nutrition at our centre and to explore risk factors predisposing patients to post-operative nutritional deficits requiring supplementation. Methods We retrospectively analysed the electronic case records of all patients undergoing a pancreaticoduodenectomy between November 2019 and November 2020 at our HPB specialist centre. Key patient demographic data and post-operative nutritional requirements with route, length and indication for supplemental feeding as well as biochemical markers, length of stay (LoS) and complications were collected and analysed. Data were analysed via intention to treat analysis. Results 48 patients underwent a pancreaticoduodenectomy, of which 26 had an NJ tube inserted intra-operatively. 16 (33%) patients required supplemental feeding, via NJ route in 7 and PN in 9. 2 patients were intolerant to NJ feeds and progressed to PN. NJ fed patients had shorter LoS (12(10-42) vs. 28(14-63) days)(p = 0.09) compared to PN feeding. PN-related line infection or thrombosis in 4 (36%) patients. Supplemental feeding met daily kcal requirements in 13 (81%) patients, but PN was associated with greater weight loss (-5%) than NJ feeding (-3%). Significantly increasing the risk of needing supplemental nutrition: advanced age(p = 0.04), ASA≥2(p = 0.04) and anastomotic leak(p = 0.02). Conclusions In this group of patients, NJ feeding was largely well-tolerated and the majority of patients met their required daily kcal via this route. Due to the increased incidence of complications associated with PN, NJ feeding should be considered as the 1st line option for post-operative nutritional supplementation, with intra-operative insertion of an NJ tube considered for higher-risk patients.

Transcriptome Adaptation of the Ovine Mammary Gland to Dietary Supplementation of Extruded Linseed

Several dietary strategies were adopted to reduce saturated fatty acids and increase beneficial fatty acids (FA) for human health. Few studies are available about the pathways/genes involved in these processes. Illumina RNA-sequencing was used to investigate changes in the ovine mammary gland transcriptome following supplemental feeding with 20% extruded linseed. Comisana ewes in mid-lactation were fed a control diet for 28 days (control period) followed by supplementation with 20% DM of linseed panel for 28 days (treatment period). Milk production was decreased by 30.46% with linseed supplementation. Moreover, a significant reduction in fat, protein and lactose secretion was also observed. Several unsaturated FAs were increased while short and medium chain saturated FAs were decreased by linseed treatment. Around four thousand (1795 up- and 2133 down-regulated) genes were significantly differentially regulated by linseed supplementation. The main pathways affected by linseed supplementation were those involved in the energy balance of the mammary gland. Principally, the mammary gland of fed linseed sheep showed a reduced abundance of transcripts related to the synthesis of lipids and carbohydrates and oxidative phosphorylation. Our study suggests that the observed decrease in milk saturated FA was correlated to down-regulation of genes in the lipid synthesis and lipid metabolism pathways.

Anti-Predator Vigilance as an Indicator of the Costs and Benefits of Supplemental Feeding in Newly Released ‘Alalā (Corvus hawaiiensis)

Although supplemental feeding is commonly used as a conservation strategy during animal translocations, it comes with a number of pros and cons which can be hard to quantify. Providing additional food resources may lead to improved physical health, survivorship, and reproduction. However, offering predictable food sources could make individuals more conspicuous to predators and less aware of their surroundings, disrupting their natural predator-prey dynamic. Decisions such as release cohort size and supplemental feeder design could influence the balance of these costs and benefits, depending on how animals behave in the face of predation risk and static food sources. Additionally, animals released to the wild from long term human care must balance foraging and predation risk while adjusting to a novel environment. To help conservation managers make informed decisions in light of these potential costs, we studied the behavior of a cohort of 11 conservation-bred ‘alalā (Corvus hawaiiensis) at supplemental feeding stations after release into the wild. Vigilance, foraging behavior and social group size was quantified via 1,320 trail camera videos of ‘alalā over the span of 12 months. We found that vigilance increased over time since release, suggesting that ‘alalā learn and adjust to their novel surroundings. Both vigilance and eating decreased with group size, indicating that although conspecifics may share the burden of scanning for threats, they also increase competition for food. We also found that the design of the feeder may have limited birds' abilities to express anti-predator behavior since less vigilance was observed in individuals that manipulated the feeder. Yet, birds may have been able to offset these costs since they increasingly scrounged for food scraps next to the feeder as time progressed. We discuss how changes to behavior over time, social interactions, and feeder design should all be considered when planning supplemental feeding as part of wildlife translocations.

Impact of management measures on the European ground squirrel population development

In the past, the European ground squirrel represented a common part of Slovakian fauna. During the 20th century, there was a substantial decrease in its number, mainly due to the intensification of agriculture. Currently, several programs focused on the recovery and preservation of ground squirrel colonies have been implemented. The aim in supporting the population of the European ground squirrel is to increase the number of birds of prey and to ensure a food base for them. In this paper, we focus on evaluating the success rate of European ground squirrel (Spermophilus citellus) management measures. The research was realized at two localities in the Protected Bird Area Slovenský kras (Hrhov and Gemerská Hôrka) in the years 2015–2018. Activities were focused on the management of grassland and supplemental feeding during the breeding period. As a result of the management measures and the supplemental feeding, we managed to maintain a positive trend in the populations’ development, as there was an increase observed in all the monitored seasons.

Effect of Early Supplemental Formula Intervention on Body Weight and Hyperbilirubinemia in Neonates During 72 h After Birth

Background: The full breastfeeding may lead to insufficient milk intake of newborns and increase the rate of body weight loss (BWL). Severe BWL was generally believed as a cause of significant hyperbilirubinemia in newborn babies. The study aimed to investigate the effect if early supplemental feeding in newborns with birth weight loss at the first 3 days after birth could decrease the rate of hyperbilirubinemia 72 h of birth.Methods: A total of 395 neonates with gestational age >37 weeks and birth body weight >2500g were prospectively collected between 2016 and 2018. We analyzed 280 neonates with BWL rate reaching the predictive value (4.5%, 7.5%, and 8% on the first, second, third day after birth, respectively) for subsequent hyperbilirubinemia after 72 hours after birth. The enrolled cases were divided into four subgroups as interventional consecutive milk supplement for 0, 1, 2, and 3 days after birth for further analysisResults: For newborns with BWL reaching the predictive value on the first day after birth, the serum bilirubin levels were lower in the experimental group than those in the non-involved control group (p < 0.05). For newborns with three consecutive days of interventional milk supplementation, the serum bilirubin levels at the 72 h after birth showed the lowest levels compared with the other sub-groups with two consecutive days and one consecutive day of interventional milk supplementation (p < 0.05). Moreover, there was a significantly decreasing trend in the consecutive days of interventional milk supplementation (p < 0.05).Conclusion: Newborns with BWL over 4.5% on the first day after birth receiving early intervention milk supplementation could significantly reduce serum bilirubin levels at the72 h after birth. The more days of consecutive milk supplementation after birth may lead to the lower the 72 h serum bilirubin levels. It is recommended to early and consecutive milk supplementation after birth to be an effective way in reducing serum bilirubin levels.

Effects of supplemental feeding on the fecal bacterial communities of Rocky Mountain elk in the Greater Yellowstone Ecosystem

Supplemental feeding of wildlife is a common practice often undertaken for recreational or management purposes, but it may have unintended consequences for animal health. Understanding cryptic effects of diet supplementation on the gut microbiomes of wild mammals is important to inform conservation and management strategies. Multiple laboratory studies have demonstrated the importance of the gut microbiome for extracting and synthesizing nutrients, modulating host immunity, and many other vital host functions, but these relationships can be disrupted by dietary perturbation. The well-described interplay between diet, the microbiome, and host health in laboratory and human systems highlights the need to understand the consequences of supplemental feeding on the microbiomes of free-ranging animal populations. This study describes changes to the gut microbiomes of wild elk under different supplemental feeding regimes. We demonstrated significant cross-sectional variation between elk at different feeding locations and identified several relatively low-abundance bacterial genera that differed between fed versus unfed groups. In addition, we followed four of these populations through mid-season changes in supplemental feeding regimes and demonstrated a significant shift in microbiome composition in a single population that changed from natural forage to supplementation with alfalfa pellets. Some of the taxonomic shifts in this population mirrored changes associated with ruminal acidosis in domestic livestock. We discerned no significant changes in the population that shifted from natural forage to hay supplementation, or in the populations that changed from one type of hay to another. Our results suggest that supplementation with alfalfa pellets alters the native gut microbiome of elk, with potential implications for population health.

Factors affecting the home range of Dinaric-Pindos brown bears

Studying how animals interact with their environment is fundamental to informing conservation and management efforts, especially when examining large, wide-ranging carnivores in human-dominated landscapes. We hypothesized that the home ranges of bears are configured to exploit supplemental food (corn) and avoid people. In 2004–2016, we tracked 10 brown bears from the Dinaric-Pindos population using GPS telemetry, then used Brownian bridge movement models to estimate their home ranges. We related seasonal home range size to circadian period and density of supplemental feeding sites using generalized linear mixed-effect models. We also used ecological-niche factor analysis to study habitat composition within home range core areas in study areas characterized by different levels of human encroachment. We found that home range size was inversely related to density of supplemental feeding sites, and bears had larger home ranges at night (x̅ = 103.3 ± 72.8 km2) than during the day (x̅ = 62.3 ± 16.6 km2). Our results also revealed that bears living in more human-influenced areas concentrated their use far from human settlements and agricultural lands but stayed close to supplemental feeding sites. Our data suggest that bears alter their space-use patterns at the home range level in response to anthropogenic land use and food availability.