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BACKGROUND: Lactoferrin is an immuno-modulatory nutrient in human milk that may be neuroprotective. METHODS: In 36 infants born <32 weeks' gestation, we sampled human milk at 14 and 28 days of chronologic age and measured lactoferrin by electrochemiluminescence multiplex immunoassay. Using 3T quantitative brain magnetic resonance imaging scans obtained at term equivalent, we estimated total and regional brain volumes. We compared outcomes between infants exposed to low (bottom tertile, range 0.06-0.13 mg/mL) vs. high (top tertile, range 0.22-0.35 mg/mL) lactoferrin using median regression in models adjusted for gestational age, birth weight z-score, sex, and postmenstrual age. RESULTS: Compared to infants exposed to low lactoferrin, infants exposed to high lactoferrin had 43.9 cc (95% CI: 7.6, 80.4) larger total brain volume, 48.3 cc (95% CI: 12.1, 84.6) larger cortical gray matter, and 3.8 cc (95% CI: 0.7, 7.0) larger deep gray matter volume at term equivalent age. Other regional brain volumes were not statistically different between groups. CONCLUSION: Higher lactoferrin exposure during the neonatal hospitalization was associated with larger total brain and gray matter volumes, suggesting that lactoferrin may have potential as a dietary supplement to enhance brain growth in the neonatal intensive care unit setting. IMPACT: This study suggests that lactoferrin, a whey protein found in human milk, may be beneficial for preterm infant brain development, and therefore has potential as a dietary supplement in the neonatal intensive care unit setting.
RESUMO
Background. Exposure to noise in the neonatal intensive care unit (NICU) has the potential to affect neonatal auditory development; sleep patterns and physiological stability; thus impacting on developmental progress.Objectives. This study aimed to identify noise sources in three NICUs in Johannesburg; South Africa; and to determine the sound levels to which neonates in incubators are exposed at various positions in the NICU. These findings were then compared with the standards recommended by the American Academy of Pediatrics (AAP).Methods. A prospective; repeated designs measure was adopted. Sound levels were recorded in 5 different areas of the NICUs at four different times of the day over the course of 3 days. Data were analysed using descriptive statistics.Results. Sound levels recorded in all the NICUs were considerably higher than those recommended by the AAP; placing vulnerable neonates at risk for developmental disorders. Significantly; most of the noise was human-generated; highlighting the need to develop awareness of the negative effects of noise in the NICU and to implement programmes to reduce noise.Conclusion. The findings have important implications for neonatal care; and highlight the importance of noise reduction and monitoring strategies in the NICU