The impact of maternal- and neonatal-associated factors on human milk's macronutrients and energy.

OBJECTIVES: To test the impact of specific maternal- and neonatal-associated factors on human milk's macronutrients and energy. METHODS: This study was conducted with the use of a human milk analyzer (HMA, MIRIS, Uppsala, Sweden). Six hundred and thirty samples of raw milk and 95 samples of donor pasteurized milk were delivered from a total of 305 mothers. RESULTS: A significant inverse correlation of fat, protein and energy content with gestational age and birth weight was established. Fat and energy were lower in colostrum, increased in transitional milk and decreased on the 30th day's mature milk compared to transitional. The rate of protein decline from colostrum to mature milk was lower in premature deliveries compared to that of full-terms, resulting in greater contents of protein in preterm mature milk. The upmost amounts of carbohydrates were found in mature milk of preterm deliveries. A positive correlation was found between maternal age and fat contents. In women with higher post-pregnancy BMI levels greater analogies of fat and energy were presented. In women suffering diet-controlled gestational diabetes (GD), lower protein and higher fat and energy levels were found. CONCLUSIONS: Prematurity, maternal age, diet-controlled GD and high post-pregnancy BMI levels were found to impose statistical significant effect on milk's macronutrients and energy.

Maternal diet and breastfeeding duration of infants after NICU hospitalization in Greece: a cohort study.

OBJECTIVES: To investigate the role of maternal diet, personal characteristics and willingness to breastfeed on breastfeeding duration of hospitalized neonates as well as to evaluate the mothers' dietetic intake based on the national recommendations. METHODS: A sample of 161 pregnant women from Athens, Greece was followed up during pregnancy, labor and the first 40 weeks of lactation. The participants attended breastfeeding classes and were interviewed regarding their nutritional habits, personal characteristics and breastfeeding intention. A multivariable logistic regression, adjusted for maternal age, smoking, weeks of gestation, body mass index, mode of delivery was conducted in order to estimate the adjusted odds ratios of breastfeeding for at least 6 months for consuming additional serves of fruit or vegetables from the recommended by the national guidelines. RESULTS: The adjusted odds ratios for breastfeeding at 6 months was 2.15 (p = 0.05) for women consumed ≥3.5 servings of fruits/day. Moreover, the participants reported low conformity with the national dietetic guidelines. CONCLUSIONS: Mothers who consumed the recommended by the NDG fruit servings/day breast-fed their hospitalized newborns for a longer period. Despite the fact that our participants were highly motivated and willing to breast-feed, we argue that this relationship is highly unlikely to be biological.

Mother's breast milk supplemented with donor milk reduces hospital and health service usage costs in low-birthweight infants.

OBJECTIVE: to compare hospital and health service usage costs of feeding low-birthweight (LBW) infants predominantly with their mother's milk, supplemented with donor milk, with donor milk and preterm formula. DESIGN: prospective matching study. SETTING: tertiary public perinatal centre, neonatal intensive care unit (NICU) and donor human milk bank. PARTICIPANTS: 100LBW infants (Group I) fed predominantly with their mother's milk from the first hour of life, supplemented (mainly for the first week of life) with donor milk, were matched on a 1:1 basis with 100LBW infants (Group II) who were fed with donor milk for the first 3 weeks of life followed by preterm formula until hospital discharge. Individualised targeted fortification of human milk was implemented in both study groups. FINDINGS: the costs of hospitalisation, doctor visits and prescription drugs for viral infections until 8 months of age were calculated for each infant. Infants fed predominantly with their mother's milk had significantly shorter hospital stays and lower hospitalisation costs. In Group I infants, the duration of enteral gavage feeding was shorter, resulting in significantly lower costs. Up to 8 months of age, Group I infants experienced fewer episodes of viral infections, and the cost of each doctor visit and drug prescription was lower for these infants. CONCLUSIONS: feeding LBW infants predominantly with their mother's milk reduces hospital and health service usage costs. IMPLICATIONS FOR PRACTICE: feeding LBW infants predominantly with their mother's milk, supplemented with donor milk, followed by exclusive breast feeding seems to result in potential savings in hospital and health service usage costs.

Improved outcomes of feeding low birth weight infants with predominantly raw human milk versus donor banked milk and formula.

OBJECTIVES: To investigate the benefits of treating low birth weight infants predominantly with mother's own raw milk and early initiation of breastfeeding (raw human milk/breast-fed infants), in comparison to feeding only with donor banked milk (until the third week of life) and afterwards a preterm formula until hospital discharge (donor banked/formula-fed infants). METHODS: One hundred and ninety-two predominantly raw human milk-fed infants (70% of raw and 30% of donor milk) were matched to 192 donor/formula-fed ones (on 1:1 ratio). Aggressive nutrition policy and targeted fortification of human milk were implemented in both groups. RESULTS: The two groups show similar demographic and perinatal characteristics. Predominantly raw milk-fed infants regained earlier their birth weight, suffered less episodes of feeding intolerance and presented a higher body length and head circumference at discharge (p < 0.001). Those treated mainly with their mothers' milk were able to initiate breastfeeding almost 2 weeks earlier compared to those fed with donor milk who achieved to be bottle-fed later on post-conceptual age (p < 0.001). Infants being breastfed until the 8th month of life conducted less visits for a viral infection to a pediatrician compared to those in the other group (p < 0.001). CONCLUSIONS: Feeding predominantly with mother's raw milk seems to result in optimal neonatal outcomes.