OPPORTUNITIES AND PERSPECTIVES OF IMMUNE NUTRITION IN PRETERM INFANTS

While mortality associated withrespiratory distress syndrome in premature infants hasbeen reduced, other morbidities associated with pretermbirth, including necrotizing enterocolitis (NEC) and sepsis,are becoming more relevant. Although the pathogenesisof these diseases remains incompletely defined andunderstood, one of the leading risk factors is the immaturityof the immune system, which determines the tendencyof premature infants to develop excessive inflammatoryresponse and disruption of the formation of "healthy" gutmicrobiota. Breastfeeding provides a protective effect dueto the wide range of immunologically active components ofthis unique product. Current data suggest that donor milk isthe best alternative to native breast milk, as the use of theformula is primarily associated with an increased risk ofNEC. The use of individual immunological components ofbreast milk, such as lactoferrin or immunoglobulins, doesnot reduce the incidence of this disease. At the same time,lactoferrin may reduce the incidence of late-onset sepsis.Pro- and prebiotics have better evidence for the preventionof these diseases, however, questions remain about thechoice of the most effective strains, dosage, duration,and safety of their use, especially in extremely prematureinfants with a birth weight <1000 g. Combined data fromexperimental and clinical studies indicate that human milkoligosaccharides may protect against NEC, however, morereliable evidence of their effectiveness is needed, as wellas the solution of technological problems associated withthe synthesis of individual oligosaccharides and their useas individual supplements. For today, clinical practices toensure mothers are optimally supported to express theirown breast milk in order to optimize breastfeeding, earlyenteral feeding, and faster increase in daily feeds are keynutritional methods to prevent NEC and late infections inpreterm infants.

Traditional, Complementary and Integrative Medicine Approaches to COVID-19: A Narrative Review

Traditional, complementary, and integrative medicine (TCIM) approaches to COVID-19 represent a paradigm shift from Western medicine, in that TCIM emphasizes prevention, encouraging wellness, and supporting health and recovery. A wide range of TCIM approaches exist: whole medical systems (such as traditional Chinese medicine), mind-body approaches, biological therapies, body-based treatments, and energy therapies. TCIM is used to help people resist infection, but people with moderate to severe COVID-19 symptoms often relied on integrative approaches using both traditional and Western medicine. It is estimated that over 90% of the infected population in Hubei China had used some form of traditional medicine to treat COVID. Ayurvedic medicine promotes immune-boosting strategies. Among biologically based therapies, there are vitamin therapies and “immune-nutrition” as well as traditional botanical treatments. Energy therapies have been promoted by the Chinese government to treat COVID-19 which may cause a loss of qi energy and an imbalance with too much yang energy in relation to yin. In many ways, it is difficult to apply Western approaches of clinical trials to TCIM, where most treatments are preventive, restorative, and highly individualized. However, the role of TCIM in COVID-19 was significant and underscores the value of TCIM approaches not just in this pandemic but for other infectious diseases as well. This is a narrative review rather than a systematic review or meta-analysis.