Supplemental Donor Milk vs Infant Formula in Moderate to Late Preterm Infants: A Randomized Clinical Trial.

Importance: High-quality evidence supports the use of pasteurized donor human milk (donor milk) in very preterm infants with insufficient maternal milk available. However, evidence to guide the use of donor milk in more mature preterm infants is lacking.

Objective: To compare the effect of donor milk vs term infant formula, used to supplement insufficient maternal milk, on the time to establish full enteral feeds in moderate to late preterm infants.

Demographics of Mothers Donating to a Nonprofit Human Milk Bank in Australia.

Background: Donated human milk is the preferred alternative source of nutrition when infants born preterm do not have access to enough maternal breast milk. Around the world, human milk banks have been established to ensure that vulnerable infants can access safe supplies of donor human milk. Milk donors are the foundation of milk banking, and understanding who donates milk in different settings is important for creating sustainable donor milk services.

Viable Spore-Forming Obligate Anaerobes Are Rare in Pasteurized Donor Human Milk: A Pilot Study.

When access to mother's own milk is limited, pasteurized donor human milk (PDHM) is the best alternative source of nutrition for high-risk preterm infants. Microbial screening of PDHM is essential to ensure its safety, as spore-forming bacteria may survive pasteurization. Standard screening will detect spore-forming bacteria that grow aerobically, such as but may miss obligate anaerobes, such as species.

Human milk improves the oral bioavailability of the poorly water-soluble drug clofazimine.

Clofazimine is an emerging drug for the treatment of cryptosporidiosis in infants. As a poorly water-soluble drug, the formulation of clofazimine in age-appropriate vehicles is challenging and often results in the use of off-label formulations. Milk-based vehicles such as human milk and bovine milk have been investigated as age-appropriate formulations and shown to increase the solubilisation of poorly water-soluble drugs via enhanced solubility in lipid digestion products in vitro.

Macronutrient content of pasteurised donor human milk: Variability between batches from single-donor pools at an Australian milk bank.

Aim: This study aimed to characterise the between-batch variability of pasteurised donor human milk (PDHM) produced from single-donor pools at Australian Red Cross Lifeblood's milk bank and identify key donor characteristics that predict macronutrient content.

Methods: Macronutrient content from 200 batches of PDHM was measured using a mid-infrared human milk analyser (Miris, Uppsala, Sweden). Linear mixed models were used to study the impact of stage of lactation and gestational age on macronutrient content.

Evaluating human milk as a drug delivery vehicle for clofazimine to premature infants.

Human milk is proposed as a drug delivery vehicle suitable for use in neonatal patients. Clofazimine, traditionally used for the treatment of leprosy and tuberculosis, is emerging as a treatment for cryptosporidiosis in infants, however its poor aqueous solubility has led to its commercial formulation as a waxy lipid formulation in a capsule, a format that is not suitable for infants. In this study, the evaluation of pasteurised human milk for the delivery of clofazimine was investigated using an in vitro lipolysis model to simulate gastric and intestinal digestion.

Emotional factors, medical interventions and mode of birth among low-risk primiparous women in Poland.

Background And Objectives: Birth is a critical event in women's lives. Since humans have evolved to give birth in the context of social support, not having it in modern settings might lead to more complications during birth. Our aim was to model how emotional factors and medical interventions related to birth outcomes in hospital settings in Poland, where c-section rates have doubled in the last decade.

Understanding Mothers' Experiences of Being Ineligible to Donate Their Milk to a Not-for-Profit Milk Bank.

Donor milk banks have strict donor screening criteria to ensure that donor milk is safe for premature or hospitalized babies. Yet little evidence is available to understand how potential donors, who are often breastfeeding their own infants, experience being ineligible ("deferred") to donate their milk to a milk bank. Interviews were conducted with 10 mothers who were permanently or temporarily deferred from donating to a large, not-for-profit milk bank in Australia.

Donor and recipient safety in human milk banking.

Aim: Australian Red Cross Lifeblood supplies pasteurised donor human milk (PDHM) to more than 30 partner hospitals across Australia. Preterm infants who receive PDHM are a highly vulnerable population but formal biovigilance programs are rare in human milk banking. Lifeblood Milk performs ongoing surveillance for both donor and recipient adverse events.

Human Milk Oligosaccharide Compositions Illustrate Global Variations in Early Nutrition.

Background: Human milk oligosaccharides (HMOs) are an abundant class of compounds found in human milk and have been linked to the development of the infant, and specifically the brain, immune system, and gut microbiome.

Objectives: Advanced analytical methods were used to obtain relative quantitation of many structures in approximately 2000 samples from over 1000 mothers in urban, semirural, and rural sites across geographically diverse countries.

Methods: LC-MS-based analytical methods were used to profile the compounds with broad structural coverage and quantitative information.

Tailoring Human Milk Oligosaccharides to Prevent Necrotising Enterocolitis Among Preterm Infants.

Necrotising enterocolitis (NEC) is a devastating disease affecting preterm infants, with little improvement in mortality rates and treatment strategies in the last 30 years. Human milk oligosaccharides (HMOs) are emerging as a potential preventive therapy, with multiple protective functions postulated. Our aim is to summarise the evidence concerning the role of HMOs in NEC development and emerging strategies to tailor the delivery of HMOs to preterm infants.

What are Optimal Bacteriological Screening Test Cut-Offs for Pasteurized Donor Human Milk Intended for Feeding Preterm Infants?

Background: Definitive criteria for microbial screening of pasteurized donor human milk are not well established and international recommendations vary.

Aims: (1) To review pasteurized donor human milk batch discard due to failed microbial screening criteria at our milk bank (following United Kingdom National Institute of Clinical Excellence guidelines), and (2) to compare our known milk discard proportion with estimated milk discard proportions that would be required by other international milk bank guidelines.

Methods: We reviewed our microbial screening results ( = 783) over 18-months (July 2018-December 2019) and compared our known milk discard proportion with estimated milk discard proportions using other international milk bank guidelines.

SARS-CoV-2 in human milk is inactivated by Holder pasteurisation but not cold storage.

Aim: As the COVID-19 pandemic evolves, human milk banks world-wide continue to provide donor human milk to vulnerable infants who lack access to mother's own milk. Under these circumstances, ensuring the safety of donor human milk is paramount, as the risk of vertical transmission of SARS-CoV-2 is not fully understood. Here, we investigate the inactivation of SARS-CoV-2 in human milk by pasteurisation and the stability of SARS-CoV-2 in human milk under cold storage.

Declining ages at menarche in an agrarian rural region of Poland.

Objective: Age at menarche in Poland has varied with political and socioeconomic changes. An increase in age at menarche corresponded to a period of economic crisis and food rationing between 1976 and 1989. Experiencing food shortages in utero or during childhood development can affect menarcheal timing, but this national effect may be buffered in local agrarian regions growing their own food.

Variation among populations in the immune protein composition of mother's milk reflects subsistence pattern.

Lay Summary: Adaptive immune proteins in mothers' milk are more variable than innate immune proteins across populations and subsistence strategies. These results suggest that the immune defenses in milk are shaped by a mother's environment throughout her life.

Background And Objectives: Mother's milk contains immune proteins that play critical roles in protecting the infant from infection and priming the infant's developing immune system during early life.

Concentrations of trace elements in human milk: Comparisons among women in Argentina, Namibia, Poland, and the United States.

Human milk contains essential micronutrients for growth and development during early life. Environmental pollutants, such as potentially toxic metals, can also be transferred to the infant through human milk. These elements have been well-studied, but changing diets and environments and advances in laboratory technology require re-examining these elements in a variety of settings.

Relationships between biomarkers of inflammation, ovarian steroids, and age at menarche in a rural Polish sample.

Objectives: To test the hypothesis that life history trade-offs between maintenance and reproductive effort would be evident through inverse associations between levels of a biomarker of inflammation [C-reactive protein (CRP)], and ovarian hormones. Associations between CRP and age at menarche were also explored.

Methods: Urinary CRP, salivary progesterone, and estradiol were measured over one menstrual cycle from rural Polish women (n = 25), representing a natural fertility sample.