Search Results (193)

Background: Late preterm delivery accounts for approximately 5% of all births. Although there is a growing body of literature recognizing that children born late preterm are at risk for mild neurodevelopmental issues, these children are often excluded from follow-up programs. From a preventive perspective, it could be useful to promote protective factors for child development. Among these, human milk feeding is highly recommended due to its advantages for child health and development. However, there is limited research on the complex interactions between late preterm birth, human milk feeding, and subsequent cognitive and emotional development. This paper aims to explore these interactions. Methods: This study focuses on late preterm children aged 8 to 12 years who are attending school. A trained psychologist conducted assessments of cognitive development using the Wechsler Intelligence Scale for Children-III (WISC-III). Additionally, the family pediatrician gathered neonatal and current growth data, while parents completed the Child Behavior Checklist 6–18 (CBCL) regarding their child’s emotional and behavioral profile. Results: A significant impact of early nutrition on children’s cognitive development was observed, with those fed human or formula milk scoring higher than those in the mixed milk group. Additionally, early feeding, high maternal and low paternal perception of externalizing difficulties significantly predicted children’s cognitive development. Conclusions: The study suggests the potential role of early nutrition and externalizing difficulties in the cognitive development of late preterm children at school age. Therefore, the inclusion of protective factors such as breastfeeding should be encouraged in future research. Full article

Aflatoxin B1 (AFB1) and its metabolite aflatoxin M1 (AFM1) are stable and carcinogenic mycotoxins that are commonly found in dairy products, posing serious food safety concerns. However, conventional degradation methods face limited degradation efficiency and high energy demand. Here, we develop an innovative polyvinylidene fluoride (PVDF) composite membrane incorporating Fe/Co-based metal-organic frameworks (MOF) (Named Fe/Co-MIL-88B(NH₂)) and CaO₂ for targeted aflatoxin removal from milk. This system integrates two synergistic mechanisms: (1) hierarchical porous MOF structures enabling superior aflatoxin adsorption capacity and peroxidase-like catalytic activity, and (2) CaO₂ acts as a controllable-release H₂O₂ donor, supplying a steady flux of reactive oxygen species without the addition of exogenous H₂O₂. Moreover, the PVDF membrane with mechanical stability offers uniform immobilization of active components, which prevents the aggregation of nanozymes. As a result, the integrated membrane achieves high degradation efficiency for AFB1 and AFM1, exceeding 95% within 60 min. By eliminating external oxidant addition and minimizing collateral nutrient damage, the technology demonstrates remarkable operational stability (>10 cycles) and milk quality preservation capability. This breakthrough establishes an efficient and reusable detoxification method, providing new opportunities for mycotoxin mitigation in dairy products through spatiotemporal control of reactive oxygen species. Full article

Background/Objectives: Sodium (Na) concentration and the sodium-to-potassium (Na/K) ratio in human milk reflect epithelial tight junction integrity and have been proposed as non-invasive biomarkers of lactational dysfunction, including subclinical mastitis and ductal obstruction. However, their discriminative performance across varied mammary duct conditions, as well as their relevance to milk quality and nutritional integrity, remain underexplored. This study aimed to evaluate the ability of Na, K and the Na/K ratio to discriminate ductal obstruction from non-obstructed lactation—including normal, mixed, and donor milk—and to assess their applicability as nutritional and clinical screening biomarkers. Methods: The study analyzed 635 human milk samples from four groups: obstructed ducts (n = 94), mixed ducts (n = 39), normal ducts (n = 102), and donor milk (n = 400). Na and K concentrations were measured using validated handheld ion-selective electrode analyzers. Statistical analyses included Quade’s ANCOVA and receiver operating characteristic curve analysis, adjusting for infant age, gestational age, birth body weight, maternal age and storage duration. Results: Na concentrations were highest in obstructed ducts (Group A: median 810 ppm, IQR 368–1725) compared with normal ducts (Group C: 220 ppm, IQR 140–283) and donor milk (Group D: 98 ppm, IQR 80–130) (p < 0.001). A similar pattern was observed for the Na/K ratio (Group A: 1.5, IQR 0.6–3.1 vs. Group C: 0.3, IQR 0.2–0.5; Group D: 0.3, IQR 0.2–0.3). After adjusting, both Na and the Na/K ratio remained significantly elevated in milk from obstructed ducts compared to non-obstructed samples (p < 0.001). Donor milk exhibited the lowest and most stable electrolyte levels. Na demonstrated excellent discriminative performance (area under the curve = 0.96), slightly outperforming the Na/K ratio (area under the curve = 0.92). Conclusions: Na concentration and the Na/K ratio in human milk are sensitive and practical biomarkers of mammary gland integrity. Given that Na alone can be measured without additional calculations, its simplicity and strong performance support its application as a potential biomarker for ductal obstruction, with implications for both lactation support and nutritional science. Full article

Background: Human milk (HM) is the optimal nutrition for preterm infants, but supplementation is often required to meet their unique nutritional needs. Donor human milk (DHM) and preterm formula are commonly used alternatives, yet their impacts on bone metabolism and clinical outcomes remain incompletely defined. Objective: To compare the effects of exclusive mother’s own milk (MOM), MOM supplemented with DHM, and MOM supplemented with preterm formula on bone metabolism markers, growth milestones, and clinical outcomes in very preterm and very low birth weight (VLBW) infants. Methods: We conducted a retrospective review of medical records for infants born at <32 weeks’ gestation or <1500 g birth weight between January 2018 and June 2023. Feeding groups included exclusive MOM (N = 135), MOM + DHM (N = 74), and MOM + Formula (N = 54). Biochemical markers were assessed at baseline and on days 7, 14, and 28. Multivariate regression analyses evaluated predictors of growth and clinical outcomes. Results: Infants in the MOM group had significantly lower gestational age and birth weight, with higher rates of respiratory morbidity. Time to full enteral feeding and duration of parenteral nutrition were longer in the MOM group, but feeding regimen was not an independent predictor of these outcomes. By day 14, the MOM group had higher alkaline phosphatase levels and lower phosphorus levels compared to mix feeding groups, but these differences resolved by day 28. Calcium levels varied between groups but remained within normal ranges. Necrotizing Enterocolitis (NEC) incidence did not differ significantly across feeding regimens and was primarily associated with longer parenteral nutrition duration. Conclusions: Supplementation of MOM with either DHM or preterm formula supported adequate growth and bone metabolism without increasing NEC risk. Feeding regimen did not independently influence time to full enteral feeding or length of hospitalization, which were driven primarily by infant maturity and clinical status. Both DHM and preterm formula are viable supplements to MOM, ensuring nutritional adequacy without adverse bone health effects. Prospective studies are needed to evaluate long-term outcomes of these feeding strategies. Full article

This study aimed to elucidate the intrinsic regulatory mechanisms by comparing milk quality, blood metabolomics, and physiological indices between high-yielding (BH, n = 15, high milk yield, daily milk yield with 4.08 ± 0.17 kg) and low-yielding (BL, n = 15, low milk yield, daily milk yield with 2.54 ± 0.26 kg) Guanzhong dairy goats during early lactation. The results showed that the lactose content in the BH group was significantly lower than that in the BL group (p < 0.05), but the total daily lactose yield was 60 g higher. No significant differences were observed in milk fat or milk protein (p > 0.05). Among blood biochemical indices, total protein (TP), glucose (GLU), and alkaline phosphatase (ALP) were significantly lower in the BH group (p < 0.05), while β-hydroxybutyrate (BHBA) was significantly higher (p < 0.05). Milk yield exhibited a highly significant negative correlation with TP and creatinine (CRE). Regarding immune and antioxidant indices, catalase (CAT), glutathione peroxidase (GSH-Px), IgM, and IL-2 were significantly elevated in the BH group (p < 0.05), while IL-6 was significantly reduced (p < 0.05). CAT and IL-2 showed positive correlations with milk yield. Using a subset of animals for in-depth profiling (n = 6 per group)Serum metabolomics identified 184 differential metabolites (114 upregulated, 70 downregulated). In the BH group, betaine, acylcarnitines, and L-valine exhibited significant negative correlations with milk yield, implicating pathways related to fatty acid -oxidation, methyl donor regulation, and amino acid metabolism. These findings indicate that high-yielding dairy goats achieve efficient lactation through enhanced fatty acid β-oxidation, optimized methyl donor regulation for milk fat synthesis, and prioritized allocation of amino acids towards the mammary gland. Full article

In neonatal care, donor human milk (DHM) is used when maternal milk is unavailable or insufficient. In several countries, including Germany, raw (i.e., unpasteurised) DHM is occasionally administered under specific clinical conditions. However, the lack of standardised, evidence-based microbiological testing protocols raises concerns about the reliability of safety assessments for this high-risk patient group. The objective of this study was to assess the performance of four culture-based microbiological methods for detecting Enterobacterales in donor human milk, using both spiked samples and raw milk. We compared the detection limits of four culture-based microbiological methods, with and without enrichment, using spiked DHM samples and 93 raw DHM samples from a single donor (limited generalisation). Artificially inoculated samples contained defined concentrations of E. coli, K. pneumoniae, and S. ureilytica. Detection limits varied by several orders of magnitude (2.86 × 10² CFU/mL to 4.90 × 10⁰ CFU/mL). In real samples, enrichment-based methods detected Gram-negative pathogens in four out of ninety-three samples (three S. ureilytica, one P. juntendi); direct plating detected none. Increasing the sample volume and applying enrichment improved detection sensitivity. Whole-genome sequencing confirmed species identity and showed that the S. ureilytica isolates from a single donor were clonally related, indicating a recurring detection pattern and underscoring the need for longitudinal microbiological monitoring. In view of the new EU SoHO Regulation classifying DHM as a Substance of Human Origin, these findings highlight the urgent need for standardised, sensitive protocols to ensure neonatal safety. Full article

Background/Objectives: Freeze-dried high-temperature short-time pasteurized human milk fortifiers offer potential for exclusive human milk feeding in preterm infants while providing necessary nutritional supplementation. However, clinical data on safety, tolerability, and growth outcomes remain limited. This study evaluated donor milk fortification compared to conventional bovine protein-based fortification. Methods: We conducted a prospective non-interventional observational cohort study with a retrospectively matched comparison cohort at University Children’s Hospital of Nuremberg. Preterm infants ≥ 30 weeks gestational age requiring mother’s own milk fortification were included. The exposed cohort (n = 32) received freeze-dried high-temperature short-time pasteurized donor milk fortifier at 1.6–4.8 g/100 mL of mother’s own milk; the matched comparison cohort (n = 32) received bovine protein-based fortifier. Primary outcomes included feeding tolerance, safety parameters, and anthropometric measurements. Cohorts were matched for birth weight (±10%), gestational age (±5 days), and fortified feeding. Results: Baseline characteristics were not significantly different: gestational ages 32.8 ± 1.0 versus 33.0 ± 1.2 weeks; birth weights 1900 ± 380 g versus 1840 ± 370 g. Excellent feeding tolerance was demonstrated across >3100 feedings. No necrotizing enterocolitis, abdominal complications, or serious adverse events occurred. Blood glucose, triglycerides, and urea remained normal. Birth weights, lengths, and head circumferences showed no significant differences. Discharge parameters including weight, length, head circumference, and length of stay were also not significantly different. Conclusions: Freeze-dried human milk fortification demonstrates excellent safety and tolerability in preterm infants ≥ 30 weeks gestational age, achieving anthropometric outcomes not significantly different to bovine protein-based fortification. However, the suboptimal protein-to-energy ratio may limit applicability for very low birth weight infants. Therefore, freeze-dried high-temperature short-time pasteurized human milk fortification is suggested to provide appropriate nutritional supplementation for preterm infants with a birth weight over 1500 g. Full article

Taranto is the main harbor in Southern Italy and one of the most industrialized cities in the country, largely due to the presence of a large industrial area that includes a major oil refinery, a cement plant, and the former ILVA steel factory, which is one of the largest steel plants in Europe. A human biomonitoring study was conducted on breast milk from two groups of women residing in areas with different levels of exposure to polychlorodibenzo-p-dioxins (PCDDs), polychlorodibenzofurans (PCDFs), and polychlorobiphenyls (PCBs). The study aimed to assess the differences in exposure between the two groups of general people, with one group classified as “exposed” and the other as “non-exposed”. Between 2015 and 2018, 150 breast milk samples were collected: 76 from the exposed group and 74 from the non-exposed group. A specific questionnaire was also administered to the donors. The data were analyzed using a robust regression approach. The results showed significant differences in the concentrations of all analyte classes between the two groups. The difference in concentration from the non-exposed to the exposed group was highly significant (TOT_TE, 5.70 vs. 7.35 pgWHO-TE/g, PCDD + PCDF 3.34 vs. 4.53 pgWHO-TE/g, DL-PCB 2.35 vs. 2.80 pgWHO-TE/g; p << 0.05), with the most notable difference observed for the Σ₁₀ (PCDFs) family (~37%). Additionally, two distinct theoretical exposure profiles were identified: one for women residing in urban peripheries and another for those living in city/town centers. Women in the peripheries were characterized by a profile of four to six chlorinated dioxin/furan congeners plus two PCB congeners, while women in the city centers exhibited a profile of six to eight chlorinated PCDD and PCDF congeners plus five to six chlorinated PCBs. Among women residing in urban peripheries, those living in the peripheries of Statte and Taranto showed the highest exposure levels. All the results appear to witness the highest exposure of the exposed women deriving from the steel plant of concern. In addition, the highest exposure levels for the analytical sum of Σ₆ (NDL-PCBs) were found in women from a municipality classified as non-exposed: Ginosa (periphery). Full article

Splicing regulatory sequences are cornerstones for exon recognition. Mutations that modify them can severely compromise mRNA maturation and protein production. A wide range of mutations, including SNPs and InDels, can influence splicing regulatory signals either directly (e.g., altering canonical donor and acceptor dinucleotides) or indirectly (e.g., creating cryptic splice sites). CSN1S1 and CSN1S2 genes encode for the two main milk proteins, αs1 and αs2 caseins, respectively. They represent a remarkable and unique example of the possibilities for alternative splicing of individual genes, both due to the high number of alternative splices identified to date and for recognized allele-specific splicing events. To date, at least 13 alleles of CSN1S1 originating from mutations that affect canonical splice sites have been described in Bos taurus (CSN1S1 A, A1, and H), Ovis aries (E, H, and I), Capra hircus (D and G), Bubalus bubalis (E, F) and Camelidae (A, C, and D). Similarly, allele-specific splicing events have been described at the CSN1S2 locus in B. taurus. (CSN1S2 D), C. hircus (CSN1S2 D), B. bubalis (CSN1S2 B, B1, and B2), Equus asinus (CSN1S2 I B), and Camelidae. This review highlights that mutations affecting canonical splice sites, particularly donor sites, are significant sources of genetic variation impacting the casein production of the main dairy livestock species. Currently, a key limitation on this topic is the lack of detailed functional and proteomic studies. Future research should leverage advanced omics technologies like long-read transcriptomics and allele-resolved RNA sequencing to characterize these splicing mechanisms, guiding precision breeding strategies. Full article

Background: Scientific literature confirms the benefits of mother’s own milk (MOM) for both term and preterm infants. The feeding of pathological newborns, in particular the very low birth weight infants (VLBWIs), is dependent on human milk. When MOM is not available, pasteurized donor human milk obtained from a recognized Human Milk Bank (HMB) is the best alternative. Research aims: This survey aims to evaluate the activity of human milk banks (HMBs) in Italy in the years 2023–2024. Methods: Following the previous three surveys performed in 2012, 2016, and 2022, a fourth survey related to 2023 and 2024 was planned in the year 2025. A questionnaire was sent to the 44 HMBs officially operating in Italy, with questions regarding their management and activity, in order to collect national-level data. Results: All 44 Italian HMBs (100%) responded to this survey. The collected data confirm the results of the previous surveys, confirming an optimal adherence to the Italian Ministerial Guidelines. Almost all the HMBs (96%) apply the principles of self-control and the HACCP system, while the home milk collection service still requires improvement. Only 68% of HMBs organize collection and transport of the donated milk from the donor’s home to the bank. In addition, this survey shows the spreading of computerization in the management of the activities of HMBs: 36.4% make use of specific software that could lead to a greater availability of donor human milk for the neonatal centers in the future. The number of donors and the amount of donated milk increased consistently compared to the previous years. Conclusions: In general, this survey shows an improvement in the results obtained in the three previous surveys, with a positive dissemination of the culture of human milk donation in Italy. The impressive response rate to the survey demonstrates the importance of a regular check-up of the activity of HMBs. Full article

Background/Objectives: Breast milk donation is increasingly recognized as a vital public health resource, providing optimal nutrition for infants who cannot be breastfed by their biological mothers. Human milk banks play a crucial role in supporting infant health, particularly for preterm and medically vulnerable infants. Despite its recognized benefits, the practice of breast milk donation and utilization remains influenced by a complex interplay of individual, social, and cultural factors. Methods: This study systematically examines how demographic and sociocultural variables are associated with attitudes and behaviors related to breast milk donation. Data were collected from 1223 Israeli mothers via questionnaires distributed through WhatsApp groups between April and May 2025. By analyzing the questionnaire results, the research identified key predictors of willingness to donate and use donated milk, as well as patterns of awareness and perceived support within different population groups. Results: Higher education (χ² = 12.87, p = 0.0016) and settlement type (χ² = 83.096, p = 0.000) were significantly associated with greater willingness to donate breast milk. Income level had no effect on donation behavior, though higher-income participants were more open to its use (χ² = 86.838, p = 0.000). Lifestyle also influenced perceptions of social support (F(2, 1220) = 259.4036, p < 0.001) and cultural support (F(2, 1220) = 601.2383, p < 0.001) of milk donation and use. Significant correlation was found between perceived cultural and social support (t = 5.140, p = 0.000), emphasizing their interrelated influence on milk donation attitudes. Conclusions: The findings assist in guiding the development of public health policies, as well as targeted awareness campaigns, to promote equitable access to donor milk services across varied communities. From the public health perspective, the findings of this study can orientate campaigns that encourage both donation and use of breast milk focusing on segments of the population in which the level of awareness is relatively low. Full article

Donor human milk (DHM) can harbor microbial contaminants that cause serious infections in premature infants. Bacillus cereus is a pathogen frequently found in DHM, capable of forming spores that can resist Holder pasteurization (62.5 °C, 30 min). Since no microbial growth is acceptable in post-pasteurized DHM, microbiological testing of pre-pasteurized DHM provides information about its contamination level to determine if it should be accepted for pasteurization. Culture is the gold standard in microbiological control but it requires 24–48 h to provide results. In this study we developed and validated a non-commercial real-time PCR assay for the detection of Bacillus cereus (BC test) in DHM specimens on a fully automated high-throughput platform, the cobas^® 6800 system. The BC test showed excellent sensitivity and specificity, repeatability and linearity over an 8-log range and a low limit of detection in milk specimens, as well as good agreement with selective culture methods. BC test was then used to systematically control all milk donations (3439) over a 24-month period. Bacillus cereus was detected in 14.2% of DHM, with monthly rates ranging from 6 to 29% and a significantly higher incidence in warmer months. Incorporating this assay into our laboratory workflow improved efficiency and reduced turnaround time. Full article

Background/Objectives: Lactating mothers have increased nutritional requirements, but nutritional adequacy is difficult to achieve. Additionally, human milk (HM) composition depends on maternal diet. However, the nutritional intake and status of mothers with hospitalized very preterm infants (MHVPIs) (<32 weeks of gestational age) have rarely been assessed. Hence, the aim of the present study was to determine the intake of macronutrients, micronutrients, and lipids, as well as the nutritional status of MHVPIs. The results were compared with a group of HM donors (HMDs), and associations with HM composition were evaluated using multiple linear regression. Methods: For dietary assessment, a 5-day dietary record including supplement intake was completed by 15 MHVPIs and 110 HMDs. Vitamins and fatty acids (FA) were determined in plasma and erythrocytes; minerals and methylmalonic acid were determined in urine; and macronutrients, vitamins, minerals, and the lipid profile were determined in HM. Results: Considering dietary reference intakes, the dietary evaluation of MHVPIs revealed a high percentage of inadequate nutrient intake in relation to total energy, as well as for iodine and vitamins B8, B9, C, D, and E. A high protein intake was observed. The percentage of energy from carbohydrates was low, whereas the percentage of energy from fat was high. However, the diet of MHVPIs did not differ substantially from the diet of HMDs. Associations were observed between the study groups (MHVPI vs. HMD) and the HM concentration of protein, several micronutrients, and fatty acids independent from intake and status. Conclusions: Deficient nutrient intakes did not appear to be exclusively related to MHVPI but rather seemed to be widespread in both study groups. However, for preterm infants, an insufficient supply of nutrients is critical and should be addressed in order to improve preterm infant’s outcomes. Furthermore, we provided additional insights into the exploration of HM by relating its composition to prematurity. Full article

Mother’s own milk (MOM) offers the highest protection for preterm and low birth weight infants. However, breastfeeding can be challenging during neonatal hospitalization. When MOM is unavailable, donor human milk (DHM) is the recommended alternative for feeding vulnerable neonates. Human milk banks (HMBs) collect, process, and deliver DHM, playing a key role in lactation support and promoting MOM availability. Although HMBs are expanding globally, scale-up remains hindered, restricting equitable DHM access. In Switzerland, despite the existence of eight HMBs, the western region lacked such a facility until 2022. To address this gap, an interdisciplinary team from the Lausanne University Hospital (CHUV) and the Swiss Red Cross Interregional Blood Transfusion Centre (TIR) collaborated to establish a regional HMB. This partnership leveraged both institutions’ available expertise, infrastructure, and resources. After two years of preparation, the CHUV Lactarium launched in 2022 with the support of the Department of Health and Social Action (DSAS) of the Canton of Vaud. This novel human milk bank–blood bank model is fully integrated into the hospital’s neonatal care, nutrition, and breastfeeding programs, operating under a strict quality and coordination system. Since its implementation, the HMB has met 100% of DHM needs, with an 80% breastfeeding bridging rate. It has had a positive impact on neonatal care, family engagement, professional interest, and community awareness of human milk. This case study illustrates how synergistic collaboration can help bridge gaps in establishing a safe, efficient, and equitable HMB model. It also offers a scalable framework adaptable to other settings. Full article

This study investigated the IgA antibodies targeting bovine serum albumin (BSA) in 27 adult celiac disease (CD) patients adhering to a gluten-free diet (GFD), compared to 123 controls (including individuals with autoimmune disorders, those with gastrointestinal cancers, and healthy donors). Serum samples were evaluated using a multiplex assay based on a microarray comprising 66 immobilized antigens, including autoantigens associated with autoimmune diseases, different albumins, cytokines, and inflammatory markers. Elevated IgA-BSA levels were detected in 22% of CD patients versus 3.25% of controls. IgA-BSA did not cross-react with milk proteins like casein, β-lactoglobulin, and γ-globulin, nor with autoantigens and human albumin, ruling out autoimmunity against self-proteins. The observed cross-reactivity with porcine albumin suggests that antibodies target epitopes shared by bovine and porcine albumin. Increased IgA-BSA levels may interfere with immunoassays performed using BSA as a stabilizer, necessitating protein-free buffers to avoid false results when testing CD patients. Elevated IgA-BSA levels may reflect ongoing gut barrier dysfunction in CD patients on a GFD, allowing dietary proteins like BSA to trigger immune responses. This study identifies a novel immune response in CD patients on a GFD, emphasizing the need for tailored diagnostic approaches (BSA-free assays) and further research into the clinical and dietary implications of IgA-BSA elevation. Full article