Special Issue "Donkey Milk and Infant Nutrition"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 October 2020).

Special Issue Editors

Prof. Dr. Enrico Bertino
E-Mail Website
Guest Editor
Neonatal Intensive Care Unit, Department of Public Health and Pediatrics, University of Turin, Turin, Italy
Interests: human milk composition; donor human milk; nutrition of preterm newborns; fortification of human milk; infant auxology; anthropometry
Prof. Dr. Massimo Agosti
E-Mail Website
Guest Editor
Neonatal and Pediatric Unit, Hospital “F. Del Ponte”, Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy
Interests: neonates; neonatal care; preterm infants; nutrition; food allergy; microbiota; human milk
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

Until the beginning of the 20th century, donkey milk (Dm) was used to feed orphan infants, unhealthy children, and the elders. At present, consumers’ interest in Dm is increasing, and this product is gaining importance and international acceptance. Compared to ruminant milk, Dm has been studied less in the past, but research interest and financial investment in Dm have recently increased. Milk from monogastric animals, rather than from ruminants, has been suggested to be more suitable for human nutrition based on its physiochemical properties. Dm was considered as an alternative ingredient in the “solid-food-based diet” or after the first year of life in sensitive infants. Previous studies observed that Dm was tolerated by children with cow milk protein allergy. Moreover, it has also been speculated that Dm is more suitable than bovine milk to be an ingredient of a human milk fortifier for VLBW (very low birth weight) infants and preterm newborns.

The aim of this Special Issue is to bring together recent research on these topics. Submissions of original research, narrative and systematic reviews, and meta-analyses will be included.

Research evaluating different aspects of infant feeding with Dm and its relation with atopic and allergic diseases will be included.

Manuscripts that investigate Dm as a constituent of human milk fortifiers are of particular interest, but other areas of research with Dm are also welcome.

We are also interested in receiving submissions of in vitro studies or experimental animal studies evaluating nutritional aspects of Dm including energy intake, dietary patterns, diet quality, and macro- and micro-nutrients.

Prof. Enrico Bertino
Prof. Massimo Agosti
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Donkey milk
  • Donkey milk fortifier for human milk
  • Preterm newborn nutrition
  • Donkey milk and feeding tolerance
  • Donkey milk and cow milk protein allergy
  • Donkey milk and antimicrobial properties
  • Biological effects and properties of donkey milk

Published Papers (5 papers)

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Research

Open AccessArticle
The “Fortilat” Randomized Clinical Trial Follow-Up: Neurodevelopmental Outcome at 18 Months of Age
Nutrients 2020, 12(12), 3807; https://doi.org/10.3390/nu12123807 - 11 Dec 2020
Viewed by 580
Abstract
Adequate nutrition is fundamental to neonatal survival and short-term outcomes, but it also has long-term consequences on quality of life and neurologic development of preterm infants. Donkey milk has been suggested as a valid alternative for children allergic to cows’ milk proteins, due [...] Read more.
Adequate nutrition is fundamental to neonatal survival and short-term outcomes, but it also has long-term consequences on quality of life and neurologic development of preterm infants. Donkey milk has been suggested as a valid alternative for children allergic to cows’ milk proteins, due to its biochemical similarity to human milk; we, hence, hypothesized that donkey milk could be a suitable basis for developing an innovative human milk fortifier for feeding preterm infants. The aim of the current study was to extend the findings and to evaluate the neurodevelopmental outcomes at 18 months of corrected age of the infants enrolled in the clinical trial named “Fortilat”. Infants born ≤1500 g and <32 weeks of gestational age were randomized to receive either a combination of bovine milk-based multicomponent fortifier and protein supplement or a combination of a novel multicomponent fortifier and protein supplement derived from donkey milk. The followed fortification protocol was the same for the two groups and the two diets were designed to be isoproteic and isocaloric. All infants enrolled were included in a developmental assessment program. The neurodevelopmental assessment was performed at 18 ± 6 months of corrected age. Minor and major neurodevelopmental impairment and General Quotient (GQ) at the Griffiths-II Mental Development Scale were considered. The GQ was considered both in continuous and as two classes: lower than and higher than (or equal to) a defined cutoff (GQcl). The difference in GQ and GQcl between the two arms was estimated using Mann–Whitney–Wilcoxon test or Fischer exact test, respectively, on the assumption of casual loss at follow-up. A further analysis was performed using generalized linear models. There were 103 children (bovine milk-derived fortifier arm = 54, donkey milk-derived fortifier arm = 49) included for the neurodevelopmental follow-up. All observations were included in the interval of 18 ± 6 months of corrected age. No significant difference was observed between the two arms in the incidence of neurologic sequelae and the GQs were similar in the two arms. Our results demonstrated no difference for the donkey milk-derived fortifier compared to standard bovine-derived fortifier regarding long-term neurodevelopmental outcomes. Full article
(This article belongs to the Special Issue Donkey Milk and Infant Nutrition)
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Open AccessArticle
The “Fortilat” Randomized Clinical Trial Follow-Up: Auxological Outcome at 18 Months of Age
Nutrients 2020, 12(12), 3730; https://doi.org/10.3390/nu12123730 - 03 Dec 2020
Viewed by 479
Abstract
Human milk fortification is a routine clinical practice for feeding preterm infants. We hypothesized that donkey milk can be a suitable basis for developing an innovative human milk fortifier. Our randomized controlled single-blind clinical trial, named “Fortilat”, evaluated the feeding tolerance, growth and [...] Read more.
Human milk fortification is a routine clinical practice for feeding preterm infants. We hypothesized that donkey milk can be a suitable basis for developing an innovative human milk fortifier. Our randomized controlled single-blind clinical trial, named “Fortilat”, evaluated the feeding tolerance, growth and clinical short-term outcomes in a population of preterm infants fed with a novel multi-component fortifier and a protein concentrate derived from donkey milk. The aim of the current study is to extend the previous findings and to evaluate the auxological outcomes of the infants enrolled in the “Fortilat” trial at 18 months of age. In the previous trial “Fortilat”, the fortification protocol followed was the same for the two groups, and the two diets were designed to be isoproteic and isocaloric. All infants enrolled in the trial were included in a premature infant developmental evaluation program consisting of hospital visits at 40 ± 1 weeks of postmenstrual age, and at 6, 12 and 18 months of corrected age. Weight, head circumference and length were expressed in z-score using neonatal Intergrowth21st and INeS charts at birth, and WHO 0–5 years growth charts at 18 months. 122 children (Bovine-arm = 62, Donkey-arm = 60) were included in this study. All the observations were recorded in the interval of 18 ± 3 months of the correct age. The two groups did not differ for head circumference, length or weight at 18 months of age. Our data show that fortifiers derived from donkey milk had not different long term auxological outcomes of standard bovine-derived fortifier, but the new donkey milk fortifier was well tolerated in our population. Full article
(This article belongs to the Special Issue Donkey Milk and Infant Nutrition)
Open AccessArticle
Impact of Storage Conditions on the Breast Milk Peptidome
Nutrients 2020, 12(9), 2733; https://doi.org/10.3390/nu12092733 - 08 Sep 2020
Cited by 1 | Viewed by 951
Abstract
Human donor milk (HDM) provides appropriate nutrition and offers protective functions in preterm infants. The aim of the study is to examine the impact of different storage conditions on the stability of the human breast milk peptidome. HDM was directly frozen at −80 [...] Read more.
Human donor milk (HDM) provides appropriate nutrition and offers protective functions in preterm infants. The aim of the study is to examine the impact of different storage conditions on the stability of the human breast milk peptidome. HDM was directly frozen at −80 °C or stored at −20 °C (120 h), 4 °C (6 h), or room temperature (RT for 6 or 24 h). The milk peptidome was profiled by mass spectrometry after peptide collection by ultrafiltration. Profiling of the peptidome covered 3587 peptides corresponding to 212 proteins. The variance of the peptidome increased with storage temperature and time and varied for different peptides. The highest impact was observed when samples were stored at RT. Smaller but significant effects were still observed in samples stored at 4 °C, while samples showed highest similarity to those immediately frozen at −80 °C when stored at −20 °C. Peptide structures after storage at RT for 24 h point to the increased activity of thrombin and other proteases cleaving proteins at lysine/arginine. The results point to an ongoing protein degradation/peptide production by milk-derived proteases. They underline the need for immediate freezing of HDM at −20 °C or −80 °C to prevent degradation of peptides and enable reproducible investigation of prospectively collected samples. Full article
(This article belongs to the Special Issue Donkey Milk and Infant Nutrition)
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Open AccessArticle
Urinary Metabolomic Profile of Preterm Infants Receiving Human Milk with Either Bovine or Donkey Milk-Based Fortifiers
Nutrients 2020, 12(8), 2247; https://doi.org/10.3390/nu12082247 - 27 Jul 2020
Cited by 2 | Viewed by 755
Abstract
Fortification of human milk (HM) for preterm and very low-birth weight (VLBW) infants is a standard practice in most neonatal intensive care units. The optimal fortification strategy and the most suitable protein source for achieving better tolerance and growth rates for fortified infants [...] Read more.
Fortification of human milk (HM) for preterm and very low-birth weight (VLBW) infants is a standard practice in most neonatal intensive care units. The optimal fortification strategy and the most suitable protein source for achieving better tolerance and growth rates for fortified infants are still being investigated. In a previous clinical trial, preterm and VLBW infants receiving supplementation of HM with experimental donkey milk-based fortifiers (D-HMF) showed decreased signs of feeding intolerance, including feeding interruptions, bilious gastric residuals and vomiting, with respect to infants receiving bovine milk-based fortifiers (B-HMF). In the present ancillary study, the urinary metabolome of infants fed B-HMF (n = 27) and D-HMF (n = 27) for 21 days was analyzed by 1H NMR spectroscopy at the beginning (T0) and at the end (T1) of the observation period. Results showed that most temporal changes in the metabolic responses were common in the two groups, providing indications of postnatal adaptation. The significantly higher excretion of galactose in D-HMF and of carnitine, choline, lysine and leucine in B-HMF at T1 were likely due to different formulations. In conclusion, isocaloric and isoproteic HM fortification may result in different metabolic patterns, as a consequence of the different quality of the nutrients provided by the fortifiers. Full article
(This article belongs to the Special Issue Donkey Milk and Infant Nutrition)
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Open AccessArticle
Effects on Gastroesophageal Reflux of Donkey Milk-Derived Human Milk Fortifier Versus Standard Fortifier in Preterm Newborns: Additional Data from the FortiLat Study
Nutrients 2020, 12(7), 2142; https://doi.org/10.3390/nu12072142 - 18 Jul 2020
Cited by 3 | Viewed by 761
Abstract
Background: Feeding intolerance is a frequent diagnosis in very preterm infants. As seen in the FortiLat trial, human milk fortification with the new donkey milk-derived human milk fortifier (DF) seems to improve feeding tolerance in these infants. The aim of this study was [...] Read more.
Background: Feeding intolerance is a frequent diagnosis in very preterm infants. As seen in the FortiLat trial, human milk fortification with the new donkey milk-derived human milk fortifier (DF) seems to improve feeding tolerance in these infants. The aim of this study was to evaluate the effects of using the DF compared with bovine milk-derived fortifier (BF) on gastroesophageal reflux (GER) in very low birth weight (VLBW) infants. Methods: Over a total of 156 preterm infants were enrolled into the FortiLat trial (GA <32 weeks and birth weight <1500 g) and randomized into the BF arm or DF arm, and we selected all infants with clinical signs of GER and cardiorespiratory (CR) symptoms. All the infants underwent CR and multichannel intraluminal impedance and pH (MII/pH) monitoring associated with gastric ultrasound to evaluate GER and gastric emptying time. Results: 10 infants were enrolled, and 5 were in the DF arm. At MII/pH, infants enrolled into the DF arm showed a lower GER frequency than BF arm infants (p = 0.036). Half gastric emptying time was similar in DF and BF arm infants (p = 0.744). Conclusion: The use of donkey-derived human milk fortifier reduced the GER frequency and consequently should be recommended in infants with feeding intolerance. Full article
(This article belongs to the Special Issue Donkey Milk and Infant Nutrition)
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