The Effect of Hyperbaric Storage on the Nutritional Value and Retention of Certain Bioactive Proteins in Human Milk.

Human milk (HM) contains the essential macronutrients and bioactive compounds necessary for the normal growth and development of newborns. The milk collected by human milk banks is stored frozen and pasteurized, reducing its nutritional and biological value. The purpose of this study was to determine the effect of hyperbaric storage at subzero temperatures (HS-ST) on the macronutrients and bioactive proteins in HM. As control samples, HM was stored at the same temperatures under 0.1 MPa. A Miris HM analyzer was used to determine the macronutrients and the energy value. The lactoferrin (LF), lysozyme (LYZ) and α-lactalbumin (α-LAC) content was checked using high-performance liquid chromatography, and an ELISA test was used to quantify secretory immunoglobulin A (sIgA). The results showed that the macronutrient content did not change significantly after 90 days of storage at 60 MPa/-5 °C, 78 MPa/-7 °C, 111 MPa/-10 °C or 130 MPa/-12 °C. Retention higher than 90% of LYZ, α-LAC, LF and sIgA was observed in the HM stored at conditions of up to 111 MPa/-10 °C. However, at 130 MPa/-12 °C, there was a reduction in LYZ and LF, by 39 and 89%, respectively. The storage of HM at subzero temperatures at 0.1 MPa did not affect the content of carbohydrates or crude and true protein. For fat and the energy value, significant decreases were observed at -5 °C after 90 days of storage.

Assessment of baby disposable diapers application for urine collection and determination of phthalate metabolites.

The baby disposable diapers were investigated as a sampling material for urine collection and validated for the evaluation of the exposure of children to xenobiotics. Phthalate metabolites detected in urine samples were chosen as proof-of-concept analytes. For the determination of phthalate metabolites in children's urine samples, high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS) was used. Two sampling approaches were compared, namely sterile containers and baby disposable diapers. Thirty urine samples from infants and toddlers were analyzed by both methods in parallel and the results were compared. It was found that for diaper sampling, lower concentrations of the metabolites were observed, however, the general distribution for particular metabolites remains the same for both methods. For most of the metabolites high determination coefficients were obtained, namely 0.9929 for MEHHP, 0.9836 for MMP, 0.9796 for MECPP, and 0.9784 for 2-cx-MMHP. For MEOHP the determination correlation coefficient was 0.9154, while for MBP was - 0.7771 and MEHP was - 0.5228. In general, for diaper sampling an underestimation for 2-cx-MMHP and MEOHP was observed, while for MMP diaper-based approach provides overestimation. However, the proposed procedure confirms the possibility of using baby disposable diapers as a material for the collection of urine samples for biomonitoring purposes and fast screening of phthalates exposure.

Changing perspectives of medical staff after Human Milk Bank opening. A single-center retrospective study of a tertiary neonatal unit.

BACKGROUND: Breast milk is an exceptional source of nutrients for neonates, delivering a unique composition of bioactive ingredients such as immunoglobulins, hormones and oligosaccharides. Our research aimed to understand the attitude of medical staff towards milk donation and its use in the NICU (Neonatal Intensive Care Unit) and to determine the influence the milk bank has had on the feeding practices of our patients after the introduction of local Human Milk Bank (HMB). METHODS: Twelve closed-question questionnaires were distributed among employees from the Department of Neonatology and Obstetrics before and after (identical set of questions) the implementation of the HMB. The attitudes of staff towards different aspect of milk banking were recorded. RESULTS: We obtained 67 fully answered questionnaires in 2019 and 48 questionnaires in 2021. After comparing the responses, the analysis of how staff's attitudes have changed was performed. As a second step, four hundred sixty-eight neonates born consecutively in December 2018 (N.=171) and then in December 2019 (N.=297), before and after the HMB introduction, respectively, participated in the study at the Medical University of Gdansk, Poland. Patients' medical charts were retrospectively analyzed. Since the assemblage of the HMB, there has been a significant improvement in the staff's attitude towards the use of donor milk (DM) (68.7% before, 93.8% after HMB) and its safety (65.7% before, 97.9% after HMB). There was also a significant increment in feeding newborns using breast milk compared to formula milk. CONCLUSIONS: HMB allows for the collection of donor milk, matching mother's-own-milk by gestational age and stage of lactation, ensuring adequate composition for the targeted nutritional requirements of premature infants. These findings support the relevance of our study, highlighting the importance and benefits of expanding HMB worldwide and increasing education for mothers and medical staff regarding donor milk.

Gestational Hypertension and Human Breast Milk Composition in Correlation with the Assessment of Fetal Growth-A Pilot Study.

BACKGROUND AND AIMS: 1 in 10 pregnant women is diagnosed with gestational hypertension. Increasing evidence suggests that preeclampsia, gestational diabetes and gestational hypertension may affect human breast milk's lactogenesis and percentage composition. We aimed to examine whether there is any significant influence of gestational hypertension on the composition of macronutrients in human breast milk and to assess its correlation with fetal growth. METHODS: A total of 72 breastfeeding women (34 diagnosed with gestational hypertension and 38 normotensive women during pregnancy) were recruited to the study at the Division of Neonatology, Medical University of Gdansk, between June and December 2022. Milk samples were collected between the 3rd and 6th day of lactogenesis. Samples were analyzed using the Miris HMA™ Human Milk Analyzer (Upsala, Sweden), which evaluates the milk composition's energy, fat, carbohydrate and protein quantity. In addition, we assessed the children's anthropometric measurements (birth weight, body length and head circumference at birth). We used logistic regression to estimate the adjusted odds ratio and 95% confidence interval. RESULTS: The mean (±standard deviation) macronutrient composition per 10 mL of milk in the GH group was 2.5 g (±0.9) of fat, 1.7 g (±0.3) of true protein, 7.7 g (±0.3) of carbohydrates and 63.2 g (±8.1) of energy, in the normotensive women group 1.0 g (±0.9) of fat, 1.7 g (±0.3) of true protein, 7.3 g (±0.4) of carbohydrates and 57.9 g (±8.6) of energy content, respectively. The fat composition was higher in the PIH group by a mean of 0.6 g (p < 0.005). Gestational hypertension had a positive, significant correlation with birth weight (p < 0.013) and the mother's pre-pregnancy weight (p < 0.005). CONCLUSIONS: In conclusion, we found significant differences between milk composition in postpartum women with gestational hypertension compared to healthy, normotensive women. Human milk from women with gestational hypertension was found to contain a higher composition of fat, carbohydrates and energy in comparison to healthy women. Our aim is to further evaluate this correlation, as well as to assess the growth rate of newborns in order to determine the need for individualized formulas for women with pregnancy-induced hypertension, those with poor lactogenesis and those who cannot or choose not to breastfeed.

From the Difficult Airway Management to Diagnosis of Retropharyngeal Synovial Cell Carcinoma.

Respiratory complications are among the most common problems addressed in neonatology in the first hours after birth, whereas the risk of any cancer in the neonatal period is 28 per million. Sarcomas, malignant mesenchymal neoplasms, account for about 8% of all neoplasms in the neonatal period. We report on a male neonate born at 36 + 4/7 weeks of gestation, diagnosed with retropharyngeal synovial carcinoma. Ineffective respiratory movements and generalized cyanosis were the first symptoms to be noted. On the ultrasound examination of the neck, a tumor of the retropharyngeal space was exposed, then visualized by an MRI of the head and neck. The biopsy analysis revealed the diagnosis of an extremely rare tumor in a neonate. The location of its growth was atypical, contributing to a diagnostic challenge. The neoplasm was treated solely with chemotherapy concordantly with the CWS protocol, individually customized for our patient. Preterm birth, as in our case, 36 + 4/7 weeks of gestation, may imply a possible need for resuscitation or support in the transition period. Aggressive high-grade tumors of the head and neck region are locally invasive and prone to metastasize. However, prognosis in infants is hard to estimate, therefore both individualized treatment and multidisciplinary care should be tailored to the needs of the patient.