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Uberos J, Sanchez-Ruiz I, Fernández-Marin E, Ruiz-López A, Cubero-Millan I, Campos-Martínez A. Breast-feeding as protective factor against bronchopulmonary dysplasia in preterm infants. Br J Nutr 2024; 131:1405-1412. [PMID: 38163989 DOI: 10.1017/s0007114523002982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Breast-feeding is associated with fewer comorbidities in very-low-birth-weight (VLBW) preterm infants. Bronchopulmonary dysplasia (BPD) of VLBW infants is a multifactorial pathology in which nutritional aspects may be of special importance. The aim of this study is to determine, in a cohort of VLBW infants, whether breast milk nutrition is associated with a reduced prevalence and severity of BPD. A retrospective study was conducted to record the intake of mother's own milk (MOM), pasteurised donor human milk or preterm formula milk in the first 2 weeks of postnatal life of 566 VLBW newborns at our hospital during the period January 2008-December 2021. After applying the relevant exclusion criteria, data for 489 VLBW infants were analysed; 195 developed some degree of BPD. Moderate or severe BPD is associated with less weight gain. Moreover, the preferential ingestion of breast milk in the first and second postnatal weeks had effects associated with lower OR for BPD, which were statistically demonstrable for mild (OR 0·16; 95 % CI 0·03, 0·71) and severe (OR 0·08; 95 % CI 0·009, 0·91) BPD. Breast-feeding during the first weeks of postnatal life is associated with a reduced prevalence of BPD, which is frequently associated with less weight gain as a result of greater respiratory effort with greater energy expenditure.
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Affiliation(s)
- Jose Uberos
- Facultad de Medicina, Universidad de Granada, Granada, Spain
- Neonatal Intensive Care Unit, San Cecilio Clinical Hospital, Granada, Spain
| | | | | | - Aida Ruiz-López
- Neonatal Intensive Care Unit, San Cecilio Clinical Hospital, Granada, Spain
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Vass RA, Mikó É, Gál C, Kőszegi T, Vass CI, Bokor S, Molnár D, Funke S, Kovács K, Bódis J, Ertl T. The Effect of Holder Pasteurization and Different Variants on Breast Milk Antioxidants. Antioxidants (Basel) 2023; 12:1857. [PMID: 37891936 PMCID: PMC10604438 DOI: 10.3390/antiox12101857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND After birth, breast milk (BM) is a known essential source of antioxidants for infants. We analyzed the non-enzymatic total antioxidant capacity (TAC), oxygen radical absorbance capacity (ORAC), and glutathione, calcium, transferrin, and total protein levels of human breast milk before and after Holder pasteurization (HoP). METHODS The collected donor BM samples were pasteurized with HoP. RESULTS HoP decreased TAC (-12.6%), ORAC (-12.1%), transferrin (-98.3%), and total protein (-21.4%) levels; HoP did not influence the glutathione concentration, and it increased the total calcium (+25.5%) concentration. Mothers who gave birth via Cesarean section had significantly lower TAC in their BM. TAC and glutathione levels were elevated in the BM of mothers over the age of 30. BM produced in the summer had higher glutathione and calcium levels compared to BM produced in the winter. The glutathione concentration in term milk samples was significantly higher in the first two months of lactation compared to the period between the third and sixth months. The transferrin level of BM for female infants was significantly higher than the BM for boys, and mothers with a BMI above 30 had increased transferrin in their samples. CONCLUSIONS Antioxidant levels in human milk are influenced by numerous factors. Environmental and maternal factors, the postpartum age at breast milk collection, and Holder pasteurization of the milk influence the antioxidant intake of the infant.
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Affiliation(s)
- Réka Anna Vass
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Obstetrics and Gynecology, Magyar Imre Hospital, 8400 Ajka, Hungary
| | - Éva Mikó
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Microbiology, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Csenge Gál
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Tamás Kőszegi
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Laboratory Medicine, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Csaba I Vass
- Obstetrics and Gynecology, Magyar Imre Hospital, 8400 Ajka, Hungary
| | - Szilvia Bokor
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Pediatrics, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Dénes Molnár
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- Department of Pediatrics, Medical School University of Pécs, 7624 Pécs, Hungary
| | - Simone Funke
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Kálmán Kovács
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - József Bódis
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
- HUN-REN-PTE Human Reproduction Research Group, 7624 Pécs, Hungary
| | - Tibor Ertl
- Department of Obstetrics and Gynecology, Medical School University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
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Verd S, Porta R, Ginovart G, Avila-Alvarez A, García-Muñoz Rodrigo F, Izquierdo Renau M, Ventura PS. Human Milk Feeding Is Associated with Decreased Incidence of Moderate-Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants. Children (Basel) 2023; 10:1267. [PMID: 37508764 PMCID: PMC10378323 DOI: 10.3390/children10071267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND An increased rate of bronchopulmonary dysplasia (BPD) is reported in extremely preterm infants. A potential role of human milk feeding in protecting against this condition has been suggested. METHODS A retrospective descriptive study was conducted based on data about morbidity in the population of infants born between 22+0 and 26+6 weeks of gestation, included in the Spanish network SEN1500 during the period 2004-2019 and discharged alive. The primary outcome was moderate-severe BPD. Associated conditions were studied, including human milk feeding at discharge. The temporal trends of BPD and human milk feeding rates at discharge were also studied. RESULTS In the study population of 4341 infants, the rate of moderate-severe BPD was 43.7% and it increased to >50% in the last three years. The factors significantly associated with a higher risk of moderate-severe BPD were birth weight, male sex, high-frequency oscillatory ventilation, duration of invasive mechanical ventilation, inhaled nitric oxide, patent ductus arteriosus, and late-onset sepsis. Exclusive human milk feeding and any amount of human milk at discharge were associated with a lower incidence of moderate-severe BPD (OR 0.752, 95% CI 0.629-0.901 and OR 0.714, 95% CI 0.602-0.847, respectively). During the study period, the proportion of infants with moderate-severe BPD fed any amount of human milk at discharge increased more than twofold. And the proportion of infants with moderate-severe BPD who were exclusively fed human milk at discharge increased at the same rate. CONCLUSIONS Our work shows an inverse relationship between human milk feeding at discharge from the neonatal unit and the occurrence of BPD.
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Affiliation(s)
- Sergio Verd
- Department of Pediatric Care Primary Unit, La Vileta Surgery, Health Sciences Research Institute (IUNICS), Balearic University, 07122 Palma, Spain
| | - Roser Porta
- Department of Pediatrics, Division of Neonatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Gemma Ginovart
- Department of Pediatrics, Division of Neonatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Alejandro Avila-Alvarez
- Division of Neonatology, Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, 15006 A Coruña, Spain
| | - Fermín García-Muñoz Rodrigo
- Division of Neonatology, Complejo Hospitalario Universitario Insular Materno-Infantil, 35016 Las Palmas, Spain
| | | | - Paula Sol Ventura
- Department of Pediatrics, Division of Neonatology, Hospital Universitari Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
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Moliner-Calderón E, Verd S, Leiva A, Ponce-Taylor J, Ginovart G, Moll-McCarthy P, Gelabert C, Figueras-Aloy J. Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy. Children (Basel) 2022; 9:children9101450. [PMID: 36291386 PMCID: PMC9600066 DOI: 10.3390/children9101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
Background. It has been well established that human milk feeding contributes to limiting lung diseases in vulnerable neonates. The primary aim of this study was to compare the need for mechanical ventilation between human milk-fed neonates with sepsis and formula-fed neonates with sepsis. Methods. All late preterm and full-term infants from a single center with sepsis findings from 2002 to 2017 were identified. Data on infant feeding during hospital admission were also recorded. Multivariate logistic regression analyses were performed to assess the impact of feeding type on ventilation support and main neonatal morbidities. Results. The total number of participants was 322 (human milk group = 260; exclusive formula group = 62). In the bivariate analysis, 72% of human milk-fed neonates did not require oxygen therapy or respiratory support versus 55% of their formula-fed counterparts (p < 0.0001). Accordingly, invasive mechanical ventilation was required in 9.2% of any human milk-fed infants versus 32% of their exclusively formula-fed counterparts (p = 0.0085). These results held true in multivariate analysis; indeed, any human milk-fed neonates were more likely to require less respiratory support (OR = 0.44; 95% CI:0.22, 0.89) than those who were exclusively formula-fed. Conclusion. Human milk feeding may minimize exposure to mechanical ventilation.
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Affiliation(s)
- Elisenda Moliner-Calderón
- Neonatal Unit, Department of Paediatrics, Santa Creu i Sant Pau Hospital, 90 Mas Casanovas Street, 08041 Barcelona, Spain
| | - Sergio Verd
- Pediatric Unit, La Vileta Surgery, Department of Primary Care, Matamusinos Street, 07013 Palma de Mallorca, Spain
- Balearic Islands Health Research Institute (IdISBa), 79 Valldemossa Road, 07120 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-600-505-246; Fax: +34-(9)-71-799534
| | - Alfonso Leiva
- Research Unit, Department of Primary Care, Escola Graduada Street, 07002 Palma de Mallorca, Spain
| | - Jaume Ponce-Taylor
- A & E Unit, Department of Primary Care, Illes Balears Street, 07014 Palma de Mallorca, Spain
| | - Gemma Ginovart
- Neonatal Unit, Department of Paediatrics, Germans Trias i Pujol Hospital, Canyet Road, 08916 Badalona, Spain
| | - Pia Moll-McCarthy
- A & E Division, Manacor Hospital, Alcudia Road, 07500 Manacor, Spain
| | - Catian Gelabert
- Department of Paediatrics, Son Espases Hospital, 79 Valldemossa Road, 07120 Palma de Mallorca, Spain
| | - Josep Figueras-Aloy
- Neonatal Unit, ICGON, Clinic Hospital, Sabino Arana Street, 08028 Barcelona, Spain
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