Hindmilk: a head start in preterm nutrition.

BACKGROUND: During the neonatal period, nutrition has a crucial impact on preterm infants' survival, growth and development. Current nutritional practices for preterm infants often fail to meet their nutritional needs and thus have potential adverse consequences for their growth and development. Hindmilk represents a promising avenue to manage this nutritional challenge. METHOD: The scientific literature was reviewed to determine the current state of knowledge about hindmilk and its effects on the growth and development of preterm infants. RESULTS: Four studies evaluating the effects of hindmilk on the growth of preterm infants were found and included in this review. These studies report contradictory findings and present serious methodological shortcomings, limiting the evidence on the potential benefits of hindmilk in preterm infants. CONCLUSIONS: A body of knowledge on the effects of hindmilk on the growth and development of preterm infants is accumulating but there is still a striking need for further investigation

Hindmilk: a head start in preterm nutrition.

BACKGROUND: During the neonatal period, nutrition has a crucial impact on preterm infants' survival, growth and development. Current nutritional practices for preterm infants often fail to meet their nutritional needs and thus have potential adverse consequences for their growth and development. Hindmilk represents a promising avenue to manage this nutritional challenge. METHOD: The scientific literature was reviewed to determine the current state of knowledge about hindmilk and its effects on the growth and development of preterm infants. RESULTS: Four studies evaluating the effects of hindmilk on the growth of preterm infants were found and included in this review. These studies report contradictory findings and present serious methodological shortcomings, limiting the evidence on the potential benefits of hindmilk in preterm infants. CONCLUSIONS: A body of knowledge on the effects of hindmilk on the growth and development of preterm infants is accumulating but there is still a striking need for further investigation

Acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants.

PURPOSE: A pilot study was conducted to assess the acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants and study procedures. SUBJECTS: Forty mothers of preterm infants born at less than 30 weeks of gestation. DESIGN: Pilot randomized controlled trial. METHODS: Mothers of preterm infants were randomly allocated to the breast milk expression education and support intervention or standard care. The experimental intervention encompassed a breast milk expression education session on 7 themes, telephone follow-up, and telephone helpline. MAIN OUTCOME MEASURES: Data related to the acceptability and feasibility of the intervention and study procedures were collected throughout the study. At the end of the study, mothers allocated to the experimental intervention completed a self-report questionnaire assessing the acceptability of each of the intervention components. RESULTS: It was feasible to recruit 70% of eligible mothers and retain 83% of mothers who consented to participate in the study. Mothers reported that all the intervention components were appropriate and effective in supporting their breast milk production. Although the reliability of the data collection method was demonstrated, the fidelity of the telephone follow-up faced some challenges. CONCLUSIONS: Both the intervention and study procedures were acceptable and feasible. Improvements related to the fidelity of the intervention would ensure the feasibility and internal validity of a larger-scale trial

Neonatal oxygen exposure in rats leads to cardiovascular and renal alterations in adulthood

Long-term vascular and renal consequences of neonatal oxidative injury are unknown. Using a rat model, we sought to investigate whether vascular function and blood pressure are altered in adult rats exposed to hyperoxic conditions as neonates. We also questioned whether neonatal O2 injury causes long-term renal damage, important in the pathogenesis of hypertension. Sprague-Dawley pups were kept with their mother in 80% O2 or room air from days 3 to 10 postnatal, and blood pressure was measured (tail cuff) from weeks 7 to 15. Rats were euthanized, and vascular reactivity (ex vivo carotid rings), oxidative stress (lucigenin chemiluminescence and dihydroethidium fluorescence), microvascular density (tibialis anterior muscle), and nephron count were studied. In male and female rats exposed to O2 as newborns, systolic and diastolic blood pressures were increased (by an average of 15 mm Hg); ex vivo, maximal vasoconstriction (both genders) and sensitivity (males only) specific to angiotensin II were increased; endothelium-dependant vasodilatation to carbachol but not to NO-donor sodium nitroprussiate was impaired; superoxide dismutase analogue prevented vascular dysfunction to angiotensin II and carbachol; vascular superoxide production was higher; and capillary density (by 30%) and number of nephrons per kidney (by 25%) were decreased. These data suggest that neonatal hyperoxia leads in the adult rat to increased blood pressure, vascular dysfunction, microvascular rarefaction, and reduced nephron number in both genders. Our findings support the hypothesis of developmental programming of adult cardiovascular and renal diseases and provide new insights into the potential role of oxidative stress in this process