Non-nutritional “paramedical” usage of human milk — knowledge and opinion of breastfeeding mothers in Poland

Objectives: The objective of this study is to understand knowledge, attitudes and practices of non-nutritional breast milkuse among lactating women in respect of skin diseases and other frequent ailments.Material and methods: The study, in the form of a questionnaire, spread on social media, was targeted at breastfeedingwomen. The questionnaire consisted of questions regarding the knowledge of non-nutritional usage of human milk, its usein practice, subjective opinion on the observed results and inclination towards future use. Chi-square tests and c-Pearsoncoefficients were used for statistical calculations.Results: A total of 1187 responses were acted upon. In the study group, 879 women claimed to have knowledge ofnon-nutritional use of human milk in respect of skin and most common ailments, whilst 688 of them claimed to use at leastone usage. The most frequently, breast milk was used for: care of cracked nipples, care of healthy skin, treatment of diaperdermatitis and treatment of neonatal acne. A correlation between duration of breastfeeding (p < 0.05) and gestational age(p < 0.05) and practical use of non-nutritional human milk was found.Conclusions: The study showed a great enthusiasm of mothers in respect of using breast milk for non-nutritional purposes,including the treatment of skin diseases and other common ailments. However, given the scant studies determining possibleconcerns surrounding these methods, there is a requirement for parental education with emphasis on the need forprompt medical examination and pertinent treatment

Lactoferrin supplementation during pregnancy — a review of the literature and current recommendations

Pregnancy is a period which requires special care and attention. Maintaining health during pregnancy helps to avoid birth related complications and is the best way of promoting a healthy birth. Besides a daily intake of folic acid, iron, iodine, vitamin D3 and A, calcium and polyunsaturated fatty-acids, as recommended by health agencies, supplementation of lactoferrin — a protein of multidirectional biological activity and proven safety of use — seems to be beneficial. A wide range of lactoferrin biological roles (including regulation of iron balance, modulation of immune responses, antimicrobial, antiviral, antioxidant, and anti-inflammatory activity) may contribute to better pregnancy and birth related outcomes

Relationship between AB0 blood groups and selected pregnancy conditions and neonatal diseases

The influence of the blood group on the occurrence and severity of diseases has aroused the curiosity of scientists for many years. The AB0 group system is the best known and described blood group system. It is also the only system whose antibodies are constantly present in the blood serum. The most common blood type in Poland, according to data provided by Honorary blood donation and blood therapy, is group A Rh+ (plus), while the least common is group AB Rh– (minus).In studies of pregnant women scientists discovered the influence of blood type in the development of preeclampsia, gestational diabetes, the risk of preterm labor, and even COVID-19 infection. The impact of the mothers’ blood group also affects the birth weight of newborns, as well as the development of hemolytic disease of the newborn due to the heterospecificity of AB0. The influence of the blood group on the increased risk of developing certain diseases and complications of the neonatal period has also been proven.Therefore, it seems important to study blood groups of pregnant women and newborns of different nationalities, correlate the results with available reports and use this knowledge in everyday clinical practice. This will help to increase the speed of detection of diseases in pregnancy and neonatal period. It will also facilitate the management of the patient depending on their blood group

Impact of gestational diabetes and other maternal factors on neonatal body composition in the first week of life: a case-control study

Objectives: Newborns of diabetic mothers are at increased risk of abnormal nutritional status at birth, thus developing metabolic disorders. The aim of this study was to evaluate the anthropometric measurements and body composition of newborns born to mothers with gestational diabetes in comparison to newborns born to mothers with normal glucose tolerance in pregnancy, in the first week of their life. Maternal factors affecting the gestational period were also evaluated. Material and methods: The study included 70 participants: neonates born to mothers with gestational diabetes (GDM) and neonates born to healthy mothers (non-GDM). A set of statistical methods (e.g., ANOVA, Kruskal-Wallis test, Chi-square test, regression, cluster analysis) was used to compare data between the study groups and to find their association with maternal factors. Results: Our approach resulted in statistically significant classification (p < 0.05) by maternal history of hypothyroidism, weight gain during pregnancy and diagnosis of GDM. Newborns of mothers diagnosed with both GDM and hypothyroidism had lower birth weight and fat mass than newborns of mothers without GDM nor hypothyroidism (p < 0.05), however this finding might be associated with high incidence of excessive gestational weight gain among healthy mothers. No differences in body composition were found between the study groups on account of maternal GDM only (p > 0.05). Conclusions: Thus, well-controlled gestational diabetes mellitus as an individual factor does not significantly affect neonatal anthropometric measurements and body composition

Donor human milk in Neonatal Intensive Care Unit — to whom, how much and how long?

Objectives: The aim of the study was to present the variability of patients who received donor human milk (DHM) during Neonatal Intensive Care Unit (NICU) hospitalization, including time of its usage and volume of portions.  Material and methods: A retrospective analysis of data was conducted for all infants admitted to the NICU at the University Hospital during the first year of the Human Milk Bank operation. One-way analysis of variance in the intergroup scheme, Kruskal-Wallis variance analysis with the Jonckheere-Tepstra test, correlation analysis using Pearson’s r and Spearmann’s rho, frequency analysis using the Fisher’s exact test were used to conduct analyses.  Results: 133 newborns received DHM. 3 groups of neonates were identified: < 32 0/7 weeks, 32 0/7–36 6/7 weeks and > 37 0/7 weeks of gestational age (GA). Time of DHM supplementation was similar in all groups and does not differ depending on the GA but preterm infants received the smallest total volume of DHM. However, infants > 37 weeks of GA had almost a threefold greater chance of abandoning breastfeeding than the others (odds ratio (OR) = 2.89, 95% CI: 0.69–12.20). There was a statistically significant, weak negative correlation between period of total parenteral nutrition and the volume of milk from the bank: rho = –0.194; p = 0.026.  Conclusions: The DHM supply did not have a negative impact on lactation and breastfeeding. Stimulation of lactation was necessary for 5–7 days. The time of DHM supply was the same regardless of GA. The majority of infants were breastfed or received only MOM on the day of discharge from the hospital

COVID-19 in pregnancy, management and outcomes among pregnant women and neonates — results from tertiary care center in Wroclaw

Objectives: A novel coronavirus — SARS CoV-2 — outbreak has, for sure, been the greatest medical challenge in recent years. The maternal and neonatal consequences of the infection are still largely unknown. Material and methods: This prospective study aims to describe the perinatal care and outcomes of SARS-CoV-2 positive pregnant women and their newborn infants during the third wave of the pandemic, in a large tertiary university center in Wroclaw/Poland from 15 February to 1 May 2021. Results: The paper describes a group of 83 women with confirmed SARS-CoV-2 infection during delivery, as well as their newborn infants (n = 84). The course of COVID-19 disease in pregnant patients was mostly asymptomatic (56%) but 31% women manifested mild to moderate symptoms and 14% had severe infection. The median gestational age at the delivery was 38 weeks. On average, 16.7% of mothers were separated from their newborns at birth, 83.3% practiced skin-to-skin, and roomed in with their babies, and 84.5% of the infants received any mother’s milk.  Preterm infants were more often borne by mothers with symptomatic course of COVID-19 infection. Need for neonatal treatment was only due to prematurity. Neonates with acquired infection (after 14th day of life) had to be treated symptomatically with fever and loose stools, only 28.5% had symptoms of respiratory failure. Conclusions:  Despite the confirmed SARS-CoV-2 infection, the majority of mother- infant dyads were in a good health condition. The data on perinatal care reported in the paper could be helpful contribution supporting childbirth physiology protection during the COVID-19 pandemic

Letter to the editor: clarifying some aspects and the terminology of individualized human milk fortification

Abstract This letter has been written by the components of the European Milk Bank Association (EMBA) Working Group on Human Milk Fortification in response to a recent paper published by Mathes et al. (BMC Pediatr. 2018 May 8;18(1):154) with the aim of drawing attention to the importance of the use of a metabolic marker to adapt protein intake in preterm infants. EMBA Working Group on Human Milk Fortification clarifies further the terminology and some specific aspects regarding individualized human milk fortification. There are two types of individualized human milk fortification: Adjustable human milk fortification and Targeted human milk fortification. Advantages and disadvantages of these methods are summarized

Additional file 2 of Central data monitoring in the multicentre randomised SafeBoosC-III trial – a pragmatic approach

Additional file 2

Central data monitoring in the multicentre randomised SafeBoosC-III trial – a pragmatic approach

Abstract Background Data monitoring of clinical trials is a tool aimed at reducing the risks of random errors (e.g. clerical errors) and systematic errors, which include misinterpretation, misunderstandings, and fabrication. Traditional ‘good clinical practice data monitoring’ with on-site monitors increases trial costs and is time consuming for the local investigators. This paper aims to outline our approach of time-effective central data monitoring for the SafeBoosC-III multicentre randomised clinical trial and present the results from the first three central data monitoring meetings. Methods The present approach to central data monitoring was implemented for the SafeBoosC-III trial, a large, pragmatic, multicentre, randomised clinical trial evaluating the benefits and harms of treatment based on cerebral oxygenation monitoring in preterm infants during the first days of life versus monitoring and treatment as usual. We aimed to optimise completeness and quality and to minimise deviations, thereby limiting random and systematic errors. We designed an automated report which was blinded to group allocation, to ease the work of data monitoring. The central data monitoring group first reviewed the data using summary plots only, and thereafter included the results of the multivariate Mahalanobis distance of each centre from the common mean. The decisions of the group were manually added to the reports for dissemination, information, correcting errors, preventing furture errors and documentation. Results The first three central monitoring meetings identified 156 entries of interest, decided upon contacting the local investigators for 146 of these, which resulted in correction of 53 entries. Multiple systematic errors and protocol violations were identified, one of these included 103/818 randomised participants. Accordingly, the electronic participant record form (ePRF) was improved to reduce ambiguity. Discussion We present a methodology for central data monitoring to optimise quality control and quality development. The initial results included identification of random errors in data entries leading to correction of the ePRF, systematic protocol violations, and potential protocol adherence issues. Central data monitoring may optimise concurrent data completeness and may help timely detection of data deviations due to misunderstandings or fabricated data