Search Results (95)

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

Objective: This study seeks to analyze the incidence of breastfeeding self-efficacy in postpartum woman who are undergoing prenatal care at the Family Health Strategy Units in the city of Tubarão, Santa Catarina (SC), Southern Brazil, from August to December 2022. Methods: An observational epidemiological study with a cross-sectional design was carried out with puerperal women—either primiparous or multiparous—who were followed in the municipal public network, along with their live-born children delivered at the maternity hospital of Hospital Nossa Senhora da Conceição in Tubarão, SC. Participants agreed to participate in the study. For data collection, an instrument developed by researchers and a validated instrument entitled Breastfeeding Self-Efficacy Scale-Short Form were used to assess the self-efficacy of breastfeeding. Results: The mean score of the Breastfeeding Self-Efficacy Scale (BSES) was 61.75 points (±6.39), indicating high self-efficacy. There was an association between the mean of the general score and/or the domains of the BSES with maternal characteristics. Women with higher education had greater technical mastery (p = 0.010), and those with previous breastfeeding experience and those who breastfed their children during the first hour of life had a higher average in the overall score and in the domains of the scale. In addition, those who planned the pregnancy (p = 0.024) and those who did not receive assistance from the milk bank (p = 0.047) had greater technical domain. Conclusions: In the present study, there was a predominance of high breastfeeding self-efficacy. It was verified that the personal and clinical aspects interfered in the self-efficacy of breastfeeding. 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

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

Bacillus cereus poses a persistent challenge for human milk banks (HMBs) due to its ability to survive Holder pasteurization (HoP; 62.5 °C for 30 min). To ensure neonatal safety, any milk found to be contaminated post-HoP must be discarded, which impacts milk supply and adds to the operational demands of HMBs. In this study, we analyzed 688 B. cereus isolates from human milk (pre- and post-HoP), as well as from patient and environmental sources, to investigate human milk contamination by B. cereus at a Canadian HMB. Despite the limited temporal and geographic scope of the collection, the isolates exhibited remarkable genomic diversity, comparable to global B. cereus collections. Phylogenetic analysis at the core genome level revealed no clear clustering by isolate source, suggesting multifactorial pathways of B. cereus contamination. Isolates surviving HoP displayed gene variants linked to sporulation and cell wall integrity, suggesting a potential basis for HoP tolerance. Our findings emphasize that while genomic analyses offer major valuable insights, they alone are insufficient to address the complexities of B. cereus contamination in HMBs. Addressing this challenge will require combining genomic tools with robust monitoring systems, improved human milk-handling protocols, and pasteurization strategies better-suited to countering B. cereus resilience. Full article

Background: Human milk (HM) offers critical short- and long-term benefits for preterm and very low birth weight (VLBW) infants. In 2021, a human milk bank (HMB) was established at the IRCCS Giannina Gaslini Institute, aiming to improve HM feeding rates in this vulnerable population. Methods: We retrospectively analyzed feeding data from 442 VLBW infants (BW < 1500 g) admitted between 2018 and 2024. Data were drawn from the Vermont Oxford Network and Italian Neonatal Network registries. Feeding modalities—exclusive HM, infant formula milk (IM), and mixed feeding (MF)—were recorded and analyzed before and after HMB introduction. Results: Before 2021, MF was predominant, with exclusive HM rates below 10%. Following HMB implementation, exclusive HM feeding increased significantly, reaching 47.2% in 2024 (p < 0.0001). Regression analysis showed a positive trend for HM (+4.84%/year, p = 0.05), and a declining trend for IM (−1.96%/year) and MF (−2.88%/year). Projections suggest HM rates may exceed 58% by 2030. Conclusions: The introduction of the HMB was associated with a significant shift in feeding practices, increasing HM use and reducing IM exposure among VLBW infants. These findings underscore the importance of institutional strategies such as donor milk availability, lactation support, and maternal education in optimizing neonatal nutrition. Ongoing efforts are essential to sustain and extend these improvements beyond NICU discharge, ensuring the long-term benefits of human milk for preterm infants. Full article

Most donor human milk (HM) banks use Holder pasteurization (HoP) to ensure microbiological safety, although it can degrade essential bioactive factors for newborns. This study evaluates the innovative ultra-high-pressure homogenization (UHPH) technology as a potential alternative. Listeria innocua, Staphylococcus carnosus, Franconibacter helveticus (formerly named Cronobacter helveticus) and Escherichia coli strains were used as surrogates for common HM pathogens according to European Milk Bank Association (EMBA) guidelines, to evaluate the efficacy of new technologies. A reconstituted powder milk formula inoculated with these strains was used to determine the most efficient conditions (those to achieve a lethality of ≥5 Log), applying treatments from 150 to 300 MPa. These treatments were later validated using inoculated HM with the same strains. Immunoglobulin (sIgA, IgG, IgM) retention was also evaluated and compared with HoP. Results showed that UHPH treatments at 200 MPa achieved a lethality > 5 Log for all strains, except for St. carnosus, which required 250 MPa for complete inactivation in HM. Unlike HoP, UHPH at 200 and 250 MPa did not significantly reduce the basal concentration of sIgA, IgG, or IgM compared with raw HM. These findings suggest UHPH as a promising alternative to HoP, maintaining both microbiological safety and immunological quality. Full article

Background/Objectives: Maternal milk feeding in the NICU (neonatal intensive care unit) for very low birth weight (VLBW) infants mitigates the effects of preterm birth. This single-center retrospective study analyzed data from VLBW infants born between 2005 and 2019 and investigated the impact on morbidity of exposure to Mother’s Own Milk (MOM), donor human milk (DHM), preterm formula (PF), during NICU hospitalization. The assessed outcomes included necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), and late-onset sepsis (LOS). The study also examined the impact of a human milk-based feeding protocol on these outcomes, adjusting for confounding factors. Methods: Statistical analysis involved correlation tests and odds ratios to assess associations between feeding types and outcomes. Results: Surgical NEC occurred in 10% of infants fed exclusively with PF, 1.3% of those fed with DHM, and was completely absent in infants fed exclusively or partially with MOM. ROP across all stages was observed in 24.3% of cases, with severe ROP at 4.7%, and PF feeding was associated with a higher risk of severe ROP; the incidence of LOS was lower in infants fed human milk (−22%/−66%) compared to 10% in formula-fed infants. BPD affected 25.5% of infants, with moderate-to-severe BPD in 22.2%. The association between NEC, LOS, and feeding was statistically significant, even after adjusting for covariates. The type of milk had a significant impact on the incidence of severe forms of all outcomes (p < 0.001). The rate of exclusive MOM feeding increased over time, reaching 45% in 2018–2019. Conclusions: These findings highlight the role of human milk in preventing NEC and LOS, in reducing the risk of severe ROP and BPD, and in promoting MOM feeding, with rates increasing significantly when DHM is available. Full article

Background: Basic healthcare may significantly decrease neonatal morbidity and mortality. Attention to this, particularly in populations where rates of potentially preventable illness and death within the first weeks of life are extremely high, will have a positive impact on global health. Objective: This manuscript presents the development and impact of a quality improvement programme to reduce the evidence–practice gap in care for neonates admitted to the NICU in a public hospital in India. The programme was locally customised for optimal and sustainable results. Method: The backbone of the project was educational exchange of neonatal nurses and physicians between Norway and India. Areas of potential improvement in the care for the neonates were mainly identified by the clinicians and focus areas were subject to dynamic changes over time. In addition, a service centre for lactation counselling and milk banking was established. Progress over the timeframe 2017–2019 was compared with baseline data. Results: The project has shown that after a collaborative effort, there is a significant reduction in mortality from 11% in the year 2016 to 5.5% in the year 2019. The morbidity was reduced, as illustrated by the decrease in the proportion of neonates with culture-proven sepsis. Nutrition improved with consumption of human milk by the NICU-admitted neonates remarkably increasing from one third to more than three forth of their total intake, and weight gain in a subgroup was shown to increase. With the introduction of family participatory care, hours of skin-to-skin contact for the neonates significantly increased. Additional indicators of improved care were also observed. Conclusions: It is feasible to reduce neonatal mortality and morbidity in a low- and middle-income hospitalised population by improving basic care including nutrition relatively inexpensively when utilising human resources. Full article

Human milk is recognized as the optimal nutrition for infants, with evidence showing it can prevent childhood death. While there are approximately 756 milk banks worldwide, predominantly located in high-income countries, human milk banking remains limited in Africa, where infant mortality rates are highest. The purpose of this review was to examine the current landscape of human milk banking in Africa, analyzing its potential to decrease infant mortality and enhance neonatal health outcomes. We explore implementation challenges, opportunities for expansion, and strategies for establishing sustainable milk banking systems across the continent. Following Arksey and O’Malley’s scoping review framework, we conducted a comprehensive analysis of peer-reviewed literature, case studies, and reports from the PubMed, Google Scholar, and African Journals Online databases through 2024. Results: South Africa leads the continent, with over 20 milk banks, while countries like Kenya, Nigeria, and Uganda have recently established programs. Significant challenges include cultural barriers and a lack of infrastructure and funding. Despite current limitations, evidence supports the significant potential of human milk banking to reduce infant mortality in Africa. Success requires addressing cultural barriers, strengthening healthcare infrastructure, and developing sustainable funding models by integrating existing maternal and child health services. Full article

Breastfeeding is fundamental for the development and protection of the newborn, and microorganisms present in breast milk are associated with the development of the infant’s intestinal microbiota. However, there are factors that interfere with breastfeeding, resulting in the need to supply donated milk to milk banks for these children. Even though there is a restriction on medications prescribed for pregnant and breastfeeding women, some antimicrobials are accepted, as long as they are used correctly and as they can increase the selection pressure for resistant bacteria. The microorganisms present in breast milk from a human milk bank were evaluated and the resistance of the isolates to antimicrobials was phenotypically characterized. In total, 184 microbial isolates were identified by mass spectrometry, of 12 bacterial genera and 1 yeast genus. There was a high prevalence of bacteria of the genus Staphylococcus, mainly S. epidermidis (33%). Resistance to antimicrobials varied among species, with a higher percentage of isolates resistant to penicillins and macrolides. Multidrug resistance was identified in 12.6% of 143 isolates. Breast milk contains a wide variety of microorganisms, mainly those of the Staphylococcus and Enterobacter genera. There was a high percentage of resistant isolates, and multidrug resistance in Klebsiella oxytoca (66.7%; 4/6) and S. epidermidis (15.0%; 9/60) isolates, which increases the public health concern. Full article

Background and Objectives: Donor human milk (DHM) from a human milk bank (HMB) is used to feed low-birthweight (LBW) and preterm infants when mothers cannot provide their own breastmilk. The misuse of DHM could interfere with mothers’ breastmilk and weaken breastfeeding efforts. This study aimed to identify factors behind prolonged DHM usage during the first six years of Vietnam’s first HMB. Methods: Data were extracted from the Da Nang HMB’s digital monitoring system. We defined prolonged DHM use as four or more days in the neonatal unit and two or more days in postnatal wards. Results: Over six years, 25,420 infants received DHM, with 45.3% of the infants being female, 54.7% being male, 70.0% being born via cesarean section, and 77.2% being full-term. In the neonatal unit (n = 7001), 38.0% of infants used DHM for ≥4 days. Adjusted odds ratios (aORs) for prolonged use were 0.14 for infants weighing <1000 g, 0.78 for infants weighing 1000–<1500 g, and 0.67 for infants weighing ≥2000 g (p < 0.01), compared to those weighing 1500–<2000 g. Compared to gestational ages of 32–<34 weeks, the aORs were 0.26 for <28 weeks, 0.71 for 34–<37 weeks, and 0.35 for ≥37 weeks (p < 0.01). In postnatal wards (n = 18,419), 53.1% of infants used DHM for ≥2 days. Compared to term, normal-weight infants, the aORs were 1.25 for LBW–preterm, 1.17 for LBW–term, and 1.21 for normal-weight–preterm infants (p < 0.05). Prolonged DHM use was associated with cesarean births in neonatal units (aOR 2.24, p < 0.01) and postnatal wards (aOR 1.44, p < 0.01). Conclusions: DHM is used briefly to bridge nutritional gaps and transition to mothers’ breastmilk, but LBW, preterm births, and cesarean births are linked to prolonged use. Healthcare providers should support those at risk of prolonged DHM use and prioritize reducing unnecessary cesarean births. Full article

Background/Objectives: One of the most effective strategies to mitigate morbidity associated with preterm birth is the use of human milk. The first choice is the mother’s milk; if that is not available, human milk donated to milk banks is the second choice. The recruitment of milk donors is essential for enhancing the effectiveness and efficiency of donation. This study aims to profile the donors of a southern Italian milk bank, examine how maternal and neonatal factors impacted the volume and duration of donation and analyze the trend over the last ten years. Materials and Methods: Data were collected from the milk bank database and hospitalization medical records, encompassing 593 donors and 13 years of activity of the Human Milk Bank from 2010 to 2022. Several variables were assessed: maternal characteristics—maternal age, employment status and the type of profession; pre and perinatal characteristics—type of delivery, parity, previous breastfeeding experience, birth weight and gestational age; milk donation characteristics—volume of milk donated and duration of donation. The trend of the characteristics was studied over time. Statistical correlations were conducted to assess the relationships between variables and the volume and duration of the milk donation. Results: In our cohort of donors, the most prevalent category consists of women over 30 years of age who are multiparous, have prior breastfeeding experience, are workers and have given birth to full-term babies. Maternal age and gestational age significantly influence both the volume and duration of milk donation. The type of delivery and occupation impact the volume of donated milk. There has been a decline in the number of donors over time. However, the trends in both the quantity and duration of milk donations have remained stable over the past decade, with the exception of the year immediately following the COVID-19 pandemic. Conclusions: We have outlined the prevailing average profile of the milk donor to a milk bank in Southern Italy. Factors impacting the volume and duration of donation, such as maternal age, occupation, type of delivery and gestational age, were identified. The volume and duration of donations have remained largely stable, with the exception of 2021, when the pandemic significantly reduced milk donations to the milk bank. Full article

The war in Ukraine and the related disruptions in its supply chains shook global markets for agricultural and energy commodities, causing their prices to increase to unprecedented levels. At the same time, this situation highlighted the fact that Ukraine is an important global producer and exporter of certain agricultural products. The complete opening of the EU market to duty-free imports from Ukraine showed that Ukrainian products constitute competition for both EU and Polish food producers. This, in turn, caused further disruptions in the food supply chains within the EU. The aim of this article is to assess the competitive position of Polish and Ukrainian food producers in the EU market and the prospects for the evolution of their competitive advantages. The analysis was carried out using selected quantitative indicators of competitive position, namely Balassa’s Revealed Comparative Advantage Index (RCA) and the Trade Coverage Index (TC). The calculations were made using statistical data from the World Bank WITS-Comtrade database. The research covered the period from 2018 to 2023, inclusive. The research shows that between 2018 and 2023, the share of products in Polish exports to the EU, in which both countries compete, increased to 37.5%; that is, both countries had comparative advantages in these products on this market. The current competition includes, among others, poultry meat, bakery products, wafers and cookies, chocolate, corn, fruit juices, frozen fruit, water and other non-alcoholic drinks, and wheat. At the same time, more than half of Polish exports consisted of products that may become the subject of such competition in the future (currently, only Poland has comparative advantages in the export of these products). These may include, among others, cigarettes, animal feed, fresh or chilled beef, other food products, smoked fish, canned meat, fish fillets, pork, canned fish, and liquid milk and cream. Therefore, Polish food producers face big challenges; the process of the post-war reconstruction of Ukraine and its potential integration with the single European market will strengthen the competitive position of Ukrainian food producers in the EU market. The current competitive strategy of Polish producers, based on cost and price advantages, may turn out to be ineffective under these conditions. Therefore, they must look for new sources of competitive advantage that will distinguish Polish products from the cheaper Ukrainian ones. Therefore, a strategy of competing on quality may prove effective. Full article

Background/Objectives: Among US breastfeeding women, those with obesity have significantly increased breast milk fat and caloric content from foremilk to hindmilk, with a 4-fold increase in fat content from the first to last milk sample. In view of different dietary norms and nutritional standards, we sought to evaluate the relationship between maternal BMI with breast milk fat and calorie content in women from Brazil, a low–middle-income country. Methods: Women who delivered singleton-term neonates were recruited from the Ana Abrao Breastfeeding Center (AABC) and Human Milk Bank at the Federal University of Sao Paulo, Brazil. These women were then studied at 7–8 weeks postpartum. Women were grouped by BMI categories of nonobese (NonOB; BMI 18.5–29.9) and obese (OB; BMI ≥ 30). A breast pump was applied, and milk samples were obtained continuously in 10 mL aliquots from foremilk to hindmilk; samples were analyzed for macronutrients and lipids, and maternal blood was analyzed for serum lipids and glucose. Results: As compared to NonOB women, those with OB had significantly higher milk fat in the mid (4.9 ± 0.3 vs. 3.9 ± 0.2) and last hindmilk (6.6 ± 0.4 vs. 5.5 ± 0.3) samples, though not in the first foremilk sample, as compared to NonOB women. In both NonOB and OB subjects, milk caloric and fat content increased 1.5 to 2-fold from foremilk to hindmilk, with the average milk caloric value being 11% greater in OB women. Protein content was significantly increased in all three milk samples (first, middle, and last) in women with OB. Conclusions: Although the value of breastfeeding remains clear, these findings may have significant implications for infant nutrition and excessive infant weight gain in women with OB. Full article