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Shenker N, Staff M, Vickers A, Aprigio J, Tiwari S, Nangia S, Sachdeva RC, Clifford V, Coutsoudis A, Reimers P, Israel‐Ballard K, Mansen K, Mileusnic‐Milenovic R, Wesolowska A, van Goudoever JB, Hosseini M, Klotz D, Grøvslien AH, Weaver G. Maintaining human milk bank services throughout the COVID-19 pandemic: A global response. Matern Child Nutr 2021; 17:e13131. [PMID: 33403779 PMCID: PMC7883204 DOI: 10.1111/mcn.13131] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023]
Abstract
If maternal milk is unavailable, the World Health Organization recommends that the first alternative should be pasteurised donor human milk (DHM). Human milk banks (HMBs) screen and recruit milk donors, and DHM principally feeds very low birth weight babies, reducing the risk of complications and supporting maternal breastfeeding where used alongside optimal lactation support. The COVID-19 pandemic has presented a range of challenges to HMBs worldwide. This study aimed to understand the impacts of the pandemic on HMB services and develop initial guidance regarding risk limitation. A Virtual Collaborative Network (VCN) comprising over 80 HMB leaders from 36 countries was formed in March 2020 and included academics and nongovernmental organisations. Individual milk banks, national networks and regional associations submitted data regarding the number of HMBs, volume of DHM produced and number of recipients in each global region. Estimates were calculated in the context of missing or incomplete data. Through open-ended questioning, the experiences of milk banks from each country in the first 2 months of the pandemic were collected and major themes identified. According to data collected from 446 individual HMBs, more than 800,000 infants receive DHM worldwide each year. Seven pandemic-related specific vulnerabilities to service provision were identified, including sufficient donors, prescreening disruption, DHM availability, logistics, communication, safe handling and contingency planning, which were highly context-dependent. The VCN now plans a formal consensus approach to the optimal response of HMBs to new pathogens using crowdsourced data, enabling the benchmarking of future strategies to support DHM access and neonatal health in future emergencies.
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Affiliation(s)
- Natalie Shenker
- Department of Surgery and CancerImperial College LondonLondonUK
- Human Milk FoundationRothamsted InstituteHertfordshireUK
| | - Marta Staff
- The Centre for Simulation, Analytics and Modelling (CSAM)University of Exeter Business SchoolExeterUK
| | - Amy Vickers
- Mothers' Milk Bank of North Texas; Human Milk Bank Association of North AmericaFort WorthTexasUSA
| | - Joao Aprigio
- Ibero‐American Human Milk Bank Program, National Milk Bank Service of Brazil, Fernandes Figueira Institute, Oswaldo Cruz Foundation – FIOCRUZMinistry of Health – BrazilBrasíliaBrazil
| | - Satish Tiwari
- Human Milk Banking Association of IndiaDr Punjabrao Deshmukh Memorial Medical CollegeAmravatiIndia
| | - Sushma Nangia
- National Human Milk Bank, Department of NeonatologyLady Hardinge Medical College & Kalawati Saran Children's HospitalNew DelhiIndia
- Vatsalya Maatri Amrit Kosh ‐ the National Comprehensive Lactation Management Centre, Department of NeonatologyLady Hardinge Medical College and Kalawati Saran Children's HospitalNew DelhiIndia
| | | | - Vanessa Clifford
- Australian Red Cross Lifeblood MilkWest MelbourneVictoriaAustralia
| | - Anna Coutsoudis
- HMBASA (Human Milk Banking Association of South Africa)South Africa
- School of Clinical Medicine, University of KwaZulu‐NatalDurbanSouth Africa
| | - Penny Reimers
- HMBASA, iThembu Lethu Community Milk BankRossburghSouth Africa
| | | | - Kimberly Mansen
- Maternal, Newborn, Child Health and NutritionPATHSeattleWashingtonUSA
| | | | - Aleksandra Wesolowska
- Laboratory of Human Milk and Lactation Research, Regional Human Milk Bank in Holy Family Hospital, Department of Medical BiologyMedical University of WarsawWarsawPoland
| | - Johannes B. van Goudoever
- Dutch National Human Milk Bank, Amsterdam UMCUniversity of Amsterdam, Emma Children's HospitalAmsterdamThe Netherlands
| | - Mohammadbagher Hosseini
- Department of NeonatologyTabriz University of Medical Sciences, Neonatal and Perinatal Department, Alzahra Teaching HospitalTabrizIran
- Full Professor of Neonatology, Pediatric Health Research Center, Tabriz University of Medical SciencesTabrizIran
| | - Daniel Klotz
- Center for Pediatrics, Division of Neonatology and Pediatric Intensive Care Medicine, Medical Center – University of Freiburg, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Anne Hagen Grøvslien
- Milk Bank Manager, Norwegian Accredited Breastfeeding Consultant, Multi‐cultural Healthcare Consultant, Department of PediatricsOslo University HospitalOsloNorway
| | - Gillian Weaver
- Human Milk FoundationRothamsted InstituteHertfordshireUK
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Affiliation(s)
- Penny Reimers
- 56394 Department of Child Health and Paediatrics, University of KwaZulu-Natal, Durban, South Africa
| | - Anna Coutsoudis
- 56394 Department of Child Health and Paediatrics, University of KwaZulu-Natal, Durban, South Africa
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Abstract
BACKGROUND The COVID-19 pandemic is disrupting normal life globally, every area of life is touched. The pandemic demands quick action and as new information emerges, reliable synthesises and guidelines for care are urgently needed. Breastfeeding protects mother and child; its health benefits are undisputed and based on evidence. To plan and support breastfeeding within the current pandemic, two areas need to be understood: 1) the clinical characteristics of COVID-19 as it applies to breastfeeding and 2) the protective properties of breastfeeding, including the practice of skin-to-skin care. This review aims to summarise how to manage breastfeeding during COVID-19. The summary was used to create guidelines for healthcare professionals and mothers. METHODS Current publications on breastfeeding during the COVID-19 pandemic were reviewed to inform guidelines for clinical practice. RESULTS Current evidence states that the Coronavirus is not transmitted via breastmilk. Breastfeeding benefits outweigh possible risks during the COVID-19 pandemic and may even protect the infant and mother. General infection control measures should be in place and adhered to very strictly. CONCLUSIONS Breastfeeding should be encouraged, mothers and infant dyads should be cared for together, and skin-to-skin contact ensured throughout the COVID-19 pandemic. If mothers are too ill to breastfeed, they should still be supported to express their milk, and the infant should be fed by a healthy individual. Guidelines, based on this current evidence, were produced and can be distributed to health care facilities where accessible information is needed.
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Affiliation(s)
- Welma Lubbe
- NuMIQ - Quality in Nursing and Midwifery, North-West University, 11 Hoffman St, Potchefstroom, South Africa.
| | - Elina Botha
- School of Health, Midwifery, Tampere University of Applied Sciences, Tampere, Finland
| | | | - Penny Reimers
- Department of Paediatrics and Child Health, University of KwaZulu Natal, Durban, South Africa
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Abstract
INTRODUCTION PiAstra is a simulated flash-heat (FH) pasteurization temperature monitoring system designed using Raspberry Pi technology for the pasteurization of human milk. This study analyzed the effect of the PiAstra FH method on human milk immune components (immunoglobulin A [IgA] and lactoferrin activity). METHODS Donor milk samples (N = 45) were obtained from a human milk bank, and pasteurized. Concentrations of IgA and lactoferrin activity were compared to their unpasteurized controls using the Student's t test. RESULTS The PiAstra FH method retained 34.2% of IgA (p < 0.0001) and 40.4% of lactoferrin activity (p < 0.0001) when compared to unpasteurized controls. The retention of IgA by the PiAstra is similar to previous FH studies, while retention of lactoferrin activity was higher than previous FH studies. DISCUSSION The high-technology, low-cost PiAstra system, which is able to retain vital immune components of human milk, provides safe donor milk for low-resourced settings. This enables the use of pasteurized donor milk when human milk is not available, potentially saving vulnerable infant lives.
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Affiliation(s)
- Brodie Daniels
- 1 Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal , Durban, South Africa
| | - Penny Reimers
- 1 Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal , Durban, South Africa
| | - Tracy King
- 2 Discipline of Microbiology, School of Life Sciences, University of KwaZulu-Natal , Pietermaritzburg, South Africa
| | - Stefan Schmidt
- 2 Discipline of Microbiology, School of Life Sciences, University of KwaZulu-Natal , Pietermaritzburg, South Africa
| | - Anna Coutsoudis
- 1 Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu-Natal , Durban, South Africa
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Kisters K, Reimers P, Kosch M, Lorenz G, Barenbrock M, Vestring T, Rahn KH. A case with renovascular hypertension. Clin Nephrol 1999; 52:263-4. [PMID: 10543330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
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Hovelius B, Andersson SI, Hagander B, Mölstad S, Reimers P, Sperlich E, Wadström T. Dyspepsia in general practice: history and symptoms in relation to Helicobacter pylori serum antibodies. Scand J Gastroenterol 1994; 29:506-10. [PMID: 8079107 DOI: 10.3109/00365529409092463] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study was designed to explore the relationships between serologic Helicobacter pylori positivity and demographic, behavioural, and symptomatologic factors in patients consulting for dyspeptic symptoms in general practice. METHODS H. pylori enzyme-linked immunosorbent assay results and checklist data were collected by general practitioners at three community health centers in southern Sweden from consecutive patients aged 18-65 years with upper abdominal pain or discomfort (dyspepsia). RESULTS Of the 130 available patients with dyspepsia, 127 agreed to participate, 45 (mean age, 41.2 years) being classified as H. pylori-positive and 82 (mean age, 33.5 years) as H. pylori-negative. Manual workers were diagnosed as H. pylori-positive significantly more often than were non-manual workers (p < 0.05). Of those patients examined earlier by gastroscopy or roentgenography, H. pylori-positives reported stomach or duodenal ulcer significantly more often than did H. pylori-negatives (p < 0.01). H. pylori-positives reported stomach/duodenal ulcer in their parents/siblings to a significantly greater extent than did H. pylori-negatives (45.2% versus 10.1%, p < 0.001). H. pylori-negatives reported stress-generated symptoms significantly more often than did H. pylori-positives (82.9% versus 61.5%, p < 0.01). Hierarchical regression analyses showed that, when age and sex were controlled for, the ability of each of these measures to predict the serologic results remained significant. CONCLUSIONS Higher levels of H. pylori antibodies in dyspeptic patients appear to be associated with a relatively low self-perception of stress, with manual work, with being older, and with the occurrence, both in the patients themselves and in their close relatives, of stomach/duodenal ulcer.
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Affiliation(s)
- B Hovelius
- Dept. of Family Medicine, Umeå University, Sweden
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Haverich A, Dammenhayn L, Demertzis S, Kemnitz J, Reimers P. Lung growth after experimental pulmonary transplantation. J Heart Lung Transplant 1991; 10:288-95. [PMID: 2031927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Replacement of the heart and both lungs or single lung transplantation has been performed in a few cases of terminal (cardio) pulmonary disease in childhood. It remains unclear whether pulmonary allografts will meet the demands of a growing organism. Six domestic pigs (mean body weight, 24 kg) underwent left lung transplantation from donors of equal weight. Immunosuppression consisted of cyclosporine, azathioprine, and corticosteroids. After the pigs doubled their body weight, growth of the lung was assessed by bronchography and pulmonary angiography. In transplant animals it took 11 weeks (normal animals, 6 weeks) for their weight to double. At that time, the bronchial tree showed similar growth when compared with nontransplant animals of equal weight. The diameter of the left lower lobe bronchus (9.2 +/- 0.4 mm) was significantly greater than that of animals of 24 kg body weight (7.5 +/- 0.3 mm; p less than 0.01) but comparable to that of normal pigs of similar weight (9.0 +/- 0.5 mm). The same applied for length of the left lower lobe bronchus (transplants, 95 +/- 6.7 mm; controls 24 kg, 67 +/- 2 mm [p less than 0.01]; controls 48 kg, 93 +/- 3 mm). Similar growth tendencies were observed in the pulmonary vascular tree. The diameter of the left lower lobe artery was 9.4 +/- 98 mm in 48 kg transplant pigs, compared with 9.7 +/- 1.2 mm in 24 kg control pigs and 8.5 +/- 0.8 mm in 48 kg control pigs. In one case of recurrent severe pulmonary rejection, the lung did not grow. We conclude from this study that growth is retarded by immunosuppression.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Haverich
- Hannover Medical School, Division of Thoracic and Cardiovascular Surgery, F.R.G
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Reimers P, Gilboy W, Goebbels J. Recent developments in the industrial application of computerized tomography with ionizing radiation. ACTA ACUST UNITED AC 1984. [DOI: 10.1016/0308-9126(84)90021-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Reimers P, Goebbels J, Weise HP, Wilding K. Some aspects of industrial non-destructive evaluation by X- and γ-ray computed tomography. ACTA ACUST UNITED AC 1984. [DOI: 10.1016/0167-5087(84)90200-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Finger W, Reimers P. [Studies on the deformation of the body of the bridge]. ZWR 1974; 83:782-5. [PMID: 4605965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Reimers P, Jost P. Notizen: Bestimmung der Wirkungsquerschnitte für die Anregung einiger kurzlebiger Isomere mit 14 MeV–Neutronen / Neutron Activation Cross-sections for the Excitation of Some Short Lived Isomeric States at 14 MeV. Zeitschrift für Naturforschung B 1974. [DOI: 10.1515/znb-1974-1-245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- P. Reimers
- Bundesanstalt für Materialprüfung, Berlin
| | - P. Jost
- Bundesanstalt für Materialprüfung, Berlin
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