OBJECTIVE: To study the association of fatty acid composition in human milk with breast milk jaundice (BMJ) in neonates. METHODS: A total of 30 full-term neonates who were admitted to the neonatal intensive care unit from October 2016 to October 2017 and were diagnosed with late-onset BMJ were enrolled as the BMJ group. Thirty healthy neonates without jaundice or pathological jaundice who were admitted to the confinement center during the same period of time were enrolled as the control group. Related clinical data were collected, including sex, mode of birth, feeding pattern, gestational age, birth weight, gravida, parity, and peak level of total serum bilirubin. Breast milk was collected from the mothers, and the MIRIS human milk analyzer was used to measure macronutrients (fat, protein, and carbohydrate) and calorie. Gas chromatography was used to analyze the content of different fatty acids in breast milk. RESULTS: The control group had higher levels of macronutrients in human milk than the BMJ group, with significant differences in fat, dry matter, and calorie ( CONCLUSIONS Some macronutrients and fatty acid composition in human milk may be associated with the pathogenesis of BMJ in neonates.
Case-Control Studies ; Fatty Acids/analysis* ; Female ; Humans ; Infant, Newborn ; Jaundice, Neonatal/etiology* ; Milk, Human/chemistry* ; Nutrients/analysis* ; Pregnancy

INTRODUCTION: Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump. METHODS: Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein. RESULTS: Median time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls. CONCLUSION LaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.
Adult ; Breast Feeding ; methods ; Breast Milk Expression ; methods ; Citrates ; analysis ; Female ; Humans ; Infant Formula ; Infant, Newborn ; Lactation ; physiology ; Milk, Human ; chemistry ; physiology ; Mothers ; Proteins ; analysis ; Sodium ; analysis ; Young Adult

The present study was designed to examine the contributions of the fatty acid elongase (ELOVL) gene polymorphisms to the levels of polyunsaturated fatty acids (PUFAs) in breast milk. Two hundred and nine healthy Han Chinese mothers were included in the study. Carriers of minor alleles of SNPs (rs2397142 and rs9357760) in ELOVL5 were associated with higher levels of linoleic acid (LA), dihomo-γ-linolenic acid (DGLA), arachidonic acid (AA), docosatetraenoic acid (DTA), docosahexenoic acid (DHA), while in rs209512 of ELOVL5 the carriers of minor alleles had lower levels of DTA compared to major homozygote alleles (P ranged from 0.004-0.046), and genetically explained variability ranged from 3.2% for eicosapentaenoic acid (EPA) to 6.0% for LA. Our findings demonstrated that common variation in ELOVL5 gene encoding rate-limiting enzymes in the metabolism of PUFAs contribute to the PUFAs in breast milk.
Acetyltransferases ; genetics ; Asian Continental Ancestry Group ; genetics ; China ; Fatty Acids, Unsaturated ; genetics ; Female ; Humans ; Milk, Human ; chemistry ; Polymorphism, Single Nucleotide

OBJECTIVETo study the effect of breast milk composition on weight growth velocity of infants fed with exclusive breast milk.

METHODSOne hundred and thirty-eight full-term singleton infants who received regular follow-up visits and fed with exclusive breast milk and their mothers were recruited. Body height, weight and head circumference of these infants were measured at regular visits. Z scores were used to evaluate growth velocity. The subjects were classified into a failure to thrive group (ΔZ scores≤-0.67), a poor growth group (-0.67<ΔZ scores<0) and a normal control group (ΔZ scores≥0). The samples of mature breast milk were collected for composition analysis. The differences in the levels of the protein, fats, energy, carbohydrates and minerals in breast milk were compared among the three groups.

RESULTSΔZ scores for weight in the failure to thrive and poor growth groups were lower than in the normal control group (P<0.05). There was no significant difference in the levels of protein, fats and energy in breast milk among the failure to thrive, poor growth and normal control groups. However, the levels of carbohydrates and minerals in both the failure to thrive and poor growth groups were lower than in the normal control group (P<0.05).

CONCLUSIONSWeight growth velocity of infants can be affected by the composition of breast milk to a certain degree in a short period. In order to maintain a good weight growth velocity of infants, mothers should have a balanced diet to improve the quality of breast milk.

Adult ; Breast Feeding ; Female ; Humans ; Infant, Newborn ; Male ; Milk, Human ; chemistry ; Weight Gain

Human breast milk is the most natural and ideal food for the baby. Breastfeeding provides benefits for maternal and child health, child immune function, growth and development, and society. The operation of human milk bank and the use of donor human milk undoubtedly provides a new way of nutrition support for the preterm infants without their own mother's milk and a new kind of treatment for other diseases. Present research on the composition of breast milk focuses on the variety and quantity of proteins, bioactive substances, probiotics and cell population.Future research may focus on the bioactive substances, the mechanism of regulation and effect of cell population, the application of probiotics and the clinical application of donor human milk.
Breast Feeding ; Female ; Humans ; Milk Banks ; Milk, Human ; chemistry ; cytology ; Probiotics ; pharmacology

PURPOSE: Extremely low birth weight infants (ELBWIs) have a high risk of acquiring cytomegalovirus (CMV) infection via breast milk and consequently developing serious symptoms. We evaluated whether freeze-thawing or pasteurization could prevent postnatal CMV infection transmitted through breast milk in ELBWIs. MATERIALS AND METHODS: Medical records of 385 ELBWIs with whole milk feeding, and freeze-thawed or pasteurized breast milk feeding were reviewed retrospectively. Postnatally acquired CMV infection was defined as an initial negative and a subsequent positive on follow-up urine CMV DNA polymerase chain reaction screening tests. The incidence, clinical characteristics, symptoms, sequelae, and long-term outcome at corrected age [(CA): 2 years of CMV infection] were analyzed. RESULTS: While no infant developed CMV infection with whole milk (0/22) or pasteurized breast milk (0/62) feeding, postnatal CMV infection was diagnosed in 8% (27/301) of ELBWIs who were fed freeze-thawed breast milk. Gestational age in the CMV group was significantly lower than the control group. In 82% (22/27) of cases, CMV infection was symptomatic and was associated with increased ventilator days and > or =moderate bronchopulmonary dysplasia (BPD). Neurodevelopmental outcome and growth status at CA 2 years were not different between the study groups. Lower gestational age and freeze-thawed breast milk feeding >60% of total oral intake during the first 8 postnatal weeks were independent risk factors for acquiring postnatal CMV infection. BPD (> or =moderate) was the only significant adverse outcome associated with this CMV infection. CONCLUSION: Pasteurization but not freeze-thawing of breast milk eradicated the postnatal acquisition of CMV infection through breast milk.
Adult ; Breast Feeding ; Bronchopulmonary Dysplasia ; Cytomegalovirus/*isolation & purification ; Cytomegalovirus Infections/epidemiology/prevention & control/*transmission ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; *Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infectious Disease Transmission, Vertical/*prevention & control ; Male ; Milk, Human/chemistry/*virology ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Retrospective Studies ; Risk Factors

Humans ; Infant ; Milk, Human ; chemistry ; Paraquat ; poisoning ; Poisoning ; diagnosis

OBJECTIVETo determine ten B-vitamins in human milk by ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS).

METHODSThe pretreated human milk samples were adequately separated and quantified within 11 min by UPLC-MS/MS with an Acquity UPLC HSS T3 column (2.1×100 mm, 1.8 µm). The mobile phase was a gradient of 2.5 mmol/L ammonium formate aqueous solution and acetonitrile at a flow rate of 0.35 mL/min. Stable isotope internal standards were used in the analysis, to correct for the method variability, including matrix and ionization effects. The homogenized human milk samples were deproteinzed using methanol, unknown contaminants were extracted with diethyl ether and hydrophobic phase was discarded. The analytes were monitored via ESI+ionization and detected in multiple reaction monitoring (MRM) with three acquisition functions.

RESULTSCalibration curves ranged from 0.5-160 ng/mL (thiamin, riboflavin, biotin, nicotinic acid, pyridoxine, pyridoxamine, pyridoxal), and 2.5-800 ng/mL (pantothenic acid, FAD and nicotinamide) (R2=0.990-0.999). The relative recovery ranged from 80.1% to 120.2%; accuracy was determined to be 98.3% to 108.0%. Intra-day and inter-day variation were 3.4%-19.9% and 5.9%-18.1%, respectively. The limit of quantification (LOQ) for all vitamins was between 0.25 and 3 µg/L.

CONCLUSIONThis method was successfully applied for simultaneous analysis of ten B-vitamins in human milk.

Chromatography, Liquid ; methods ; Humans ; Milk, Human ; chemistry ; Reproducibility of Results ; Sensitivity and Specificity ; Tandem Mass Spectrometry ; methods ; Vitamin B Complex ; chemistry

OBJECTIVETo investigate the correlation between the status of sialic acid (SA) during perinatal period and early intelligence development of healthy full term infant, and to explore the effect of SA on the early intelligence development.

METHODA total of 127 pairs of healthy mothers-neonates in the Affiliated Hospital of Nantong University were recruited randomly in this prospective cohort study. The levels of SA from body fluids of mothers-neonates were measured by enzyme-linked immunosorbent assay, such as the full-term maternal and cord blood and the colostrum. The questionnaire surveys were carried out in mothers and mental development evaluation according to Children's Development Center of China (CDCC) were carried out in infants 3 to 4 months of age to obtain the mental development index (MDI) and psycho-motor development index (PDI).

RESULTA total of 120 pairs of maternal-neonatal subjects with complete data were included into statistical analysis. The levels of SA of maternal and cord blood and colostrum were (2.25 ± 0.02), (1.21 ± 0.01), and (5.01 ± 0.06) mmol/L respectively. MDI and PDI of infants 3 to 4 months of age were (99.40 ± 1.87) and (98.53 ± 1.96). The analysis using multiple linear regression indicated that MDI was associated with SA levels of cord blood and colostrum (β = 0.636, 0.175, P < 0.05), and PDI was also associated with them (β = 0.502, 0.262, P < 0.05). The levels of SA of cord blood and colostrums were individually divided into high-level group and low-level one according to the median level. MDI and PDI in high-level group of cord blood were both significantly higher than that in low-level group (111.85 ± 2.79) vs. (108.88 ± 2.0) , (101.08 ± 4.44) vs. (98.88 ± 2.0) P < 0.01. So were MDI and PDI in high-level group of colostrum compared with those in low-level group (111.71 ± 3.07) vs. (108.81 ± 1.56), P < 0.01; (101.29 ± 4.23) vs.(98.56 ± 1.79), P < 0.05. The analysis on correlation between the levels of maternal-neonatal body fluids showed that the level of SA of colostrum was positively correlated with that of cord blood (r = 0.507, P = 0.004). However, no correlation was found either between the level of SA of maternal and cord blood or between the level of SA of maternal blood and colostrums. Further division into high-level and low-level groups was done according to the median level of maternal blood. The levels of SA of colostrum and cord blood in high-level group were markedly higher than those in low-level one (5.12 ± 0.35) vs. (4.87 ± 0.22) and (1.21 ± 0.02) vs. (1.17 ± 0.01), P < 0.05.

CONCLUSIONHigh levels of SA of cord blood and colostrums might be beneficial to the early intelligence development of full term infant. Abundant intake of SA during perinatal period and good function of placenta may play important role in early intelligence development.

Adult ; Child Development ; Colostrum ; chemistry ; Enzyme-Linked Immunosorbent Assay ; Female ; Fetal Blood ; chemistry ; Humans ; Infant ; Infant, Newborn ; Intelligence ; Intelligence Tests ; Male ; Milk, Human ; chemistry ; N-Acetylneuraminic Acid ; analysis ; Nervous System ; growth & development ; Pregnancy ; Prospective Studies ; Surveys and Questionnaires

BACKGROUNDInfancy is a critical period of growth and physiological development, in which breast milk is the best source of nutrients. Compared to western countries, research on breast milk of Chinese population are limited. Thus, it is necessary to measure breast milk energy and macronutrient concentrations of healthy urban Chinese mothers at different lactation stages, to expand the database of milk composition of Chinese population, and to examine whether dietary or other maternal factors can affect the levels of macronutrients in breast milk.

METHODSBreast milk of full expression of one side breast from 436 urban Chinese lactating mothers at 5-11 days, 12-30 days, 31-60 days, 61-120 days, and 121-240 days postpartum was obtained at 9:00 a.m. to 11:00 a.m. Total energy, lactose, protein, and fat contents were measured. 24-hour dietary recall was surveyed, and maternal nutrient intakes were analyzed.

RESULTSMilk composition changed over the course of lactation and large individual variations were documented. The concentrations were 61.3 kcal/dl for total energy, 7.1 g/dl for lactose, 0.9 g/dl for protein, and 3.4 g/dl for fat in mature milk. Stage of lactation was a strong factor affecting milk composition. Minimal evidence was found for associations between maternal current dietary intake and milk macronutrient concentration, consistently with prior research. Maternal body mass index (BMI) was positively associated with milk fat content, to a greater extent than did dietary intake. All other maternal characteristics were not significant for milk composition.

CONCLUSIONThese findings suggest that milk composition is generally weakly associated with maternal factors except for stage of lactation, and is likely to be more susceptible to long-term maternal nutritional status than short-term dietary fluctuation.

Adolescent ; Adult ; Body Mass Index ; Female ; Humans ; Lactation ; physiology ; Middle Aged ; Milk, Human ; chemistry ; Mothers ; Young Adult