scholarly journals Parent and Provider Perspectives on the Imprecise Label of “Human Milk Fortifier” in the NICU

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 720
Author(s):  
Jennifer Canvasser ◽  
Amy B. Hair ◽  
Jae H. Kim ◽  
Sarah N. Taylor
Keyword(s):  
Human Milk ◽  
Healthcare Providers ◽  
Milk Product ◽  
Not Given ◽  
Online Surveys ◽  
Product Report ◽  
Donor Human Milk ◽  
Provider Perspectives ◽  
Human Milk Fortifier ◽  
Infants Feeding

In the critical care of preterm infants, feeding is complex and potentially harmful to an immature gastrointestinal system. Parents have expressed the desire to be fully informed about what is being fed to their child, as this places them in the best position to nurture their child’s health. In the parent-engaged setting of the Necrotizing Enterocolitis Symposium, NICU parents expressed concern and confusion about how cow’s milk product and donor human milk product both carry the label “Human Milk Fortifier” (HMF). Accordingly, two online surveys were developed to characterize how the label HMF is used and interpreted in the NICU by parents and providers. Of 774 United States participants, only 21.9% of providers reported consistently describing the source of HMF to parents, and only 20.6% of parents whose child received an HMF product report knowing the source. Parents expressed that they were “not given information” regarding HMF, while both parents and healthcare providers expressed that “the label (HMF) is misleading”. This study documents the ambiguity around the label HMF as well as the need for more specific language and clearer communication.

scholarly journals The Effect of Donor Human Milk Fortification on The Adhesion of Probiotics In Vitro

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 182 ◽  
Author(s):  
Anastasia Mantziari ◽  
Satu Tölkkö ◽  
Artur C. Ouwehand ◽  
Eliisa Löyttyniemi ◽  
Erika Isolauri ◽  
...  
Keyword(s):  
Human Milk ◽  
Liquid Scintillation ◽  
Adhesion Properties ◽  
Protein Supplements ◽  
Donor Human Milk ◽  
Probiotic Strains ◽  
Human Milk Fortifier ◽  
The Impact ◽  
And Storage

Preterm delivery complications are the primary cause of death among children under the age of five. Preventive strategies include the use of pasteurized donor human milk (DHM), its fortification with human milk fortifiers (protein supplements), and supplementation with probiotics. Our aim was to examine the impact of DHM and fortified DHM (FDHM) on the mucus adhesion properties of two widely used probiotics. The study covered two forms of human milk fortifier, liquid and powdered, with or without probiotics and storage at 4 °C for 24 h. To test the adhesion properties of the probiotic strains, DHM+probiotics and FDHM+probiotics were prepared and added to immobilized mucus isolated from the stool of healthy Finnish infants. The probiotic adhesion was then measured by liquid scintillation. Our results suggest that addition of liquid or powdered human milk fortifier in donor human milk had no impact on probiotic adhesion. In addition, given the increased adhesion of probiotics suspended in buffer, other matrices should be further studied. These factors need to be considered when designing future intervention strategies using probiotics in preterm infants.

scholarly journals Quality study of Holder pasteurization of donor human milk in a neonatal personalized nutrition unit

2021 ◽  
Author(s):  
Sylvia Caballero Martín ◽  
Maria del Carmen Sánchez Gómez de Orgaz ◽  
Manuel Sánchez Luna
Keyword(s):  
Human Milk ◽  
Personalized Nutrition ◽  
Donor Human Milk ◽  
Quality Study

scholarly journals High-Temperature Short-Time and Holder Pasteurization of Donor Milk: Impact on Milk Composition

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 114
Author(s):  
Diana Escuder-Vieco ◽  
Juan M. Rodríguez ◽  
Irene Espinosa-Martos ◽  
Nieves Corzo ◽  
Antonia Montilla ◽  
...  
Keyword(s):  
High Temperature ◽  
Human Milk ◽  
Milk Composition ◽  
Donor Human Milk ◽  
High Temperature Short Time ◽  
Lactose Concentration ◽  
C 30 ◽  
Milk Banks ◽  
Short Time

Holder pasteurization (HoP; 62.5 °C, 30 min) is commonly used to ensure the microbiological safety of donor human milk (DHM) but diminishes its nutritional properties. A high-temperature short-time (HTST) system was designed as an alternative for human milk banks. The objective of this study was to evaluate the effect of this HTST system on different nutrients and the bile salt stimulated lipase (BSSL) activity of DHM. DHM was processed in the HTST system and by standard HoP. Macronutrients were measured with a mid-infrared analyzer. Lactose, glucose, myo-inositol, vitamins and lipids were assayed using chromatographic techniques. BSSL activity was determined using a kit. The duration of HTST treatment had a greater influence on the nutrient composition of DHM than did the tested temperature. The lactose concentration and the percentage of phospholipids and PUFAs were higher in HTST-treated than in raw DHM, while the fat concentration and the percentage of monoacylglycerides and SFAs were lower. Other nutrients did not change after HTST processing. The retained BSSL activity was higher after short HTST treatment than that following HoP. Overall, HTST treatment resulted in better preservation of the nutritional quality of DHM than HoP because relevant thermosensitive components (phospholipids, PUFAs, and BSSL) were less affected.

scholarly journals Connected diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shannen M. C. van Duijn ◽  
Angela K. Siteyi ◽  
Sherzel Smith ◽  
Emmanuel Milimo ◽  
Leon Stijvers ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Healthcare Providers ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
Structured Interviews ◽  
National Guidelines ◽  
Private Providers ◽  
Provider Perspectives ◽  
Treatment Data ◽  
Sub Saharan

Abstract Background In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is currently not sufficient to control malaria. Transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu. Methods Our intervention was performed Oct 2017–Dec 2018 across five private providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled to malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews. Results In total 11,689 febrile patients were digitally tested through five private providers. Malaria positivity ranged from 7.4 to 30.2% between providers, significantly more amongst the poor (p < 0.05). Prescription of antimalarials was substantially aberrant from National Guidelines, with 28% over-prescription (4.6–63.3% per provider) and prescription of branded versus generic antimalarials differing amongst facilities and correlating with the socioeconomic status of clients. Challenges were encountered transitioning from microscopy to RDT. Conclusion We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improvement potential.

scholarly journals Effects of human milk fortifier on the antimicrobial properties of human milk

2006 ◽  
Vol 26 (12) ◽  
pp. 761-763 ◽  
Author(s):  
F Ovalı ◽  
İH Çiftçi ◽  
Z Çetinkaya ◽  
A Bükülmez
Keyword(s):  
Human Milk ◽  
Antimicrobial Properties ◽  
Human Milk Fortifier

New Operating Approach to Limit Bacillus Cereus Contamination of Donor Human Milk

2021 ◽  
pp. 089033442110025
Author(s):  
Domenica Mallardi ◽  
Pasqua Piemontese ◽  
Nadia Liotto ◽  
Rosaria M. Colombo ◽  
Antonella Dodaro ◽  
...  
Keyword(s):  
Human Milk ◽  
Bacillus Cereus ◽  
Donor Human Milk

Donor Human Milk and Its Nutritional Properties

2016 ◽  
Vol 32 (2) ◽  
pp. 390-391 ◽  
Author(s):  
Chiara Peila ◽  
Alessandra Coscia ◽  
Enrico Bertino ◽  
Laura Cavallarin ◽  
Marzia Giribaldi ◽  
...  
Keyword(s):  
Human Milk ◽  
Nutritional Properties ◽  
Donor Human Milk

scholarly journals Effects of human milk fortifier with iron on the bacteriostatic properties of breast milk

2013 ◽  
Vol 89 (4) ◽  
pp. 394-399
Author(s):  
Leticia Fuganti Campos ◽  
João Carlos Domingues Repka ◽  
Mário Cícero Falcão
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Human Milk Fortifier
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