The Influence of Early Nutrition on Neurodevelopmental Outcomes in Preterm Infants.

Premature infants, given their limited reserves, heightened energy requirements, and susceptibility to nutritional deficits, require specialized care. AIM: To examine the complex interplay between nutrition and neurodevelopment in premature infants, underscoring the critical need for tailored nutritional approaches to support optimal brain growth and function. DATA SOURCES: PubMed and MeSH and keywords: preterm, early nutrition, macronutrients, micronutrients, human milk, human milk oligosaccharides, probiotics AND neurodevelopment or neurodevelopment outcomes. Recent articles were selected according to the authors' judgment of their relevance. Specific nutrients, including macro (amino acids, glucose, and lipids) and micronutrients, play an important role in promoting neurodevelopment. Early and aggressive nutrition has shown promise, as has recognizing glucose as the primary energy source for the developing brain. Long-chain polyunsaturated fatty acids, such as DHA, contribute to brain maturation, while the benefits of human milk, human milk oligosaccharides, and probiotics on neurodevelopment via the gut-brain axis are explored. This intricate interplay between the gut microbiota and the central nervous system highlights human milk oligosaccharides' role in early brain maturation. CONCLUSIONS: Individualized nutritional approaches and comprehensive nutrient strategies are paramount to enhancing neurodevelopment in premature infants, underscoring human milk's potential as the gold standard of nutrition for preterm infants.

Side Effects of Phototherapy on Neonates.

Phototherapy in neonates for treatment of pathological jaundice is an effective therapeutic tool that is widely used in neonatal units. Over the past years, a greater concern has emerged about the effects on the immune and inflammatory system and its potential genotoxic and side effects, especially the late ones, possibly associated with childhood diseases, showing that this treatment is not as harmless as previously believed. Numerous studies assessing these possible adverse effects of phototherapy on neonates have been published over the past years. Through this review, we seek to analyze what we know about the side effects of phototherapy in the neonatal period. The main causes of jaundice, phototherapy techniques, acute and late side effects, and effects on the immune and inflammatory system were reviewed. It was concluded that phototherapy is not a treatment free of side effects and further studies need to be conducted to elucidate its harmful effects on neonates.

Expression of neutrophil surface markers in icteric neonates before and after phototherapy.

BACKGROUND: Jaundice due to indirect hyperbilirubinemia affects more than 60% of neonates and phototherapy is the treatment for severe types. There are no previous studies evaluating the effect of phototherapy on the function of neonates neutrophils. The aim of this study was to assess and compare the function of neutrophils by measuring the expression of neutrophils main surface markers in icteric neonates before and after phototherapy. METHODS: Neonates at a gestational age ≥35 weeks and birth weight ≥2,000 g who met the American Academy of Pediatrics criteria for phototherapy were included. Flow cytometry evaluation of the mean fluorescence intensities of CD10, CD11b, CD11c, CD15, CD16, CD18, CD62L, CD64, and CD66acde was performed before and 24 h after the initiation of phototherapy. RESULTS: Twenty-five neonates at a mean age of 53 h of life were included in the study with a mean bilirubin level of 13.60 ± 2.85 mg/dL. There was no statistical difference in the expression of CD11b, CD15, CD18, CD62L, and CD64 or in the percentage of neutrophils before and after 24 h of phototherapy. There was an increase in the expression of CD10 and CD16 and a decrease in the expression of CD11c and CD66acde after 24 h of phototherapy. CONCLUSIONS: Newborns submitted to phototherapy had an increase in the expression of CD10 and CD16 and a decreased in the expression of CD11c and CD66acde after 24 h of treatment, which may be related to an anti-inflammatory effect of phototherapy. © 2018 International Clinical Cytometry Society.

Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants.

BACKGROUND: Long term effects of massage therapy in very preterm newborns infants are still to be described. Few studies evaluated neurodevelopment just at six months, and included late preterm infants. OBJECTIVE: To study the effect of massage therapy on neurodevelopment of very low birth weight infants at two years corrected age. STUDY DESIGN: Newborns with birth weight between >or= 750 and

The influence of phototherapy on serum cytokine concentrations in newborn infants.

We sought to determine cytokine response in term and late preterm newborn infants on phototherapy. Twenty newborn infants with gestational age > or = 35 weeks and birth weight > or = 2000 g in the first week of life had serum interleukin (IL)-6, IL-8, IL-10, IL-1beta, and tumor necrosis factor (TNF)-alpha measured immediately prior to and after 24 hours on phototherapy. Exclusion criteria were newborns with severe congenital malformations, congenital infections, birth asphyxia, sepsis, hemolytic anemia that required blood transfusion, maternal-infant Rh incompatibility and those who required exchange transfusion or intravenous immunoglobulin treatment for hyperbilirubinemia. Median IL-6 concentrations significantly decreased after 24 hours on phototherapy (18.3 pg/mL and 7.85 pg/mL, respectively, p = 0.005). IL-6 concentrations decreased in 17 out of the 20 newborns. There were no statistical differences in IL-8, IL-10, IL-1beta, and TNF-alpha concentrations before and after 24 hours on phototherapy. There was a statistically significant correlation between IL-6 decline and irradiance (r = 0.57, p = 0.009). The finding that serum IL-6 decreases in newborn under phototherapy suggests that phototherapy possibly has an anti-inflammatory effect, although the clinical implications of this study deserve further studies.