Evaluation of Total Antioxidant Capacity and Total Oxidant Status of Preterm and Term Breast Milk during the Course of Lactation and within a Nursing Session.

OBJECTIVE: Breast milk (BM) contains antioxidant molecules which may offer protection against oxidative stress (OS). We aim to investigate oxidant-antioxidant balance in preterm BM during the course of lactation and within a nursing session. STUDY DESIGN: Total antioxidant capacity (TAC) and total oxidant status (TOS) were measured in colostrum, transitional, and mature BM samples of preterm infants born earlier than 34th week of pregnancy and healthy term infants. Oxidative stress index (OSI) was calculated. Foremilk and hindmilk samples were collected separately. RESULTS: In colostrum and transitional milk, TAC (p < 0.001 and p = 0.001, respectively) and TOS (p = 0.005 and p < 0.001, respectively) were lower in preterm BM compared with term BM. OSI was also lower in preterm BM, but it was statistically significant only in transitional milk (p < 0.001). TAC was highest in colostrum and decreased through the course of lactation. However, the decrease in TAC was not statistically significant in preterm BM. Lowest values of TOS and OSI were observed in colostrum. In transitional term BM, hindmilk had a better oxidant-antioxidant profile as indicated by lower TOS and OSI. CONCLUSION: Oxidant-antioxidant balance is preserved in BM in every stage of lactation. Preterm BM has lower OSI which may offer benefits to preterm newborn against OS.

Employing a Nutrition Nurse in Neonatal Intensive Care Unit Improved Nutrition and Growth Outcomes in Preterm Neonates.

BACKGROUND: Nutrition nurses are clinical nurse specialists with knowledge and experience in nutrition support. We aimed to investigate the nutrition and growth outcomes after employment of a nutrition nurse in our level III neonatal intensive care unit (NICU). METHODS: A retrospective cohort study including preterm neonates < 34 weeks and < 2000 g were conducted. Nutrition and growth outcomes of infants in pre-nutrition-nurse and post-nutrition-nurse periods were compared. Primary outcome was presence of postnatal growth retardation (PGR) at term-equivalent age (body weight < 10 percentile at 40 weeks postmenstrual age). RESULTS: Infants in pre-nutrition-nurse (n = 38) and post-nutrition-nurse (n = 40) periods were similar with regard to gestational age, birth weight, gender, and perinatal characteristics. The initiation of parenteral nutrition after admission to NICU (30.8 ± 24.1 vs 6.7 ± 7.6 hours, P < 0,001) and attainment of full enteral feedings (27.3 ±18.1 vs 18.7 ± 11.3 days, P = 0.034) were earlier in post-nutrition-nurse period. First feeds were more commonly started with breast milk (29% vs 75%, P < 0.001); breastfeeding was more common at discharge (79% vs 95%, P = 0.045) and longer in duration (6.1 ± 7.3 vs 8.4 ± 6.3 months, P = 0.008) in post-nutrition-nurse period. Primary outcome PGR at term-equivalent age was lower in post-nutrition-nurse period (57.9% vs 27.5%, P = 0.007). CONCLUSION: Employing a nutrition nurse improved quality of nutrition support, increased breastfeeding, and decreased PGR in preterm neonates. Further prospective evaluation of outcomes in the presence of a nutrition nurse is needed to generalize these findings to other NICUs.