Promoting implementation of “Good and Best Practices” through Health Promotion and Prevention Registries

Health promotion and disease prevention programme registries can play an important role in increasing transparency of “good/ best Practices” and promoting their implementation. In the EU, there are different approaches to how registries seek to support the implementation of practices. However, there is limited knowledge of the extent to which there are informative differences or overlaps in the mechanisms chosen for accreditation, capacity building and implementation. This presentation focuses on six national registries in the EU (Finland, Germany, Italy, Netherlands, Poland, Slovenia) and the European Public Health Best Practice Portal. Information was obtained through a working group on Good/ Best Practice Portals, established in 2019. Information on the process of adding good/best practices to the registry and on measures that promote implementation was gathered and evaluated through a descriptive case comparison. The comparison suggests that implementation can be promoted through different approaches for capacity building measures and incentives for implementation. The latter included funding resources, titling/awarding of practice and professional feedback in only a few registries. Registries may be useful not only for transparency of good and best Practices but also for implementation through capacity building and several incentives. The information provided in this presentation may be informative in guiding development of similar resources elsewhere and a starting point for discussion on how to support best the implementation of good/ best practices.

Effects of Holder pasteurization on the protein profile of human milk

BACKGROUND

The most widespread method for the treatment of donor milk is the Holder pasteurization (HoP). The available literature data show that HoP may cause degradation of some bioactive components. The aim of this study was to determine the effect of HoP on the protein profile of human milk (HM) using a GeLC-MS method, a proteomic approach and a promising technique able to offer a qualitative HM protein profile.

METHODS

HM samples were collected by standardized methods from 20 mothers carrying both preterm and term newborns. A aliquot of each sample was immediately frozen at -80 °C, whilst another one was Holder pasteurized and then frozen. All samples were then analyzed by GeLC-MS. The protein bands of interest were excised from the gel, digested with trypsin and identified by nano-HPLC-MS/MS analysis.

RESULTS

The protein profile before and after HoP showed qualitative differences only in 6 samples out of 20, while in the remaining 14 no detectable differences were found. The differences interested only colostrums and transitional milk samples and regarded the decrease of the electrophoretic bands corresponding to alpha and beta-casein, tenascin, lactoferrin and immunoglobulin.

CONCLUSIONS

In the majority of samples, HoP did not cause any modification, thereby preserving the biological activity of HM proteins.

Evaluation of the galactogogue effect of silymarin on mothers of preterm newborns (<32 weeks)

Hypogalactia has a relative high frequency in women having delivered preterm infants, who often have difficulties in maintaining a sufficient production of milk for their infants’ needs over prolonged periods of time. Recent studies have shown a potential galactogogue effect of silymarin on milk production in animal models (cows and rats) and in humans (mothers of term newborns); nonetheless, none of the studies conducted on humans consisted of double-blind randomized clinical trials and no data are available concerning mothers who delivered preterm infants. The aim of our study was to assess the efficacy of silymarin (BIO-C^®) as galactogogue and its tolerability in mothers who delivered preterm infants. We enrolled 50 mothers at 10±1 days <em>post-partum</em> who had delivered infants at ® and placebo arms. No adverse events were observed in the 2 arms among mothers and infants, and silymarin and its metabolites were not detectable in the analyzed human milk samples. Further investigation on specific patient groups affected by hypogalactia, defined according to stricter criteria, should be planned to assess the efficacy of the product in increasing milk production.