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Coscia A.,University of Turin | Peila C.,University of Turin | Bertino E.,University of Turin | Coppa G.V.,Marche Polytechnic University | And 6 more authors.
Journal of Pediatric Gastroenterology and Nutrition | Year: 2015

OBJECTIVES:: The benefits of human milk for preterm infants are mainly the result of its nutritional characteristics and the presence of biologically active compounds. Among these compounds, glycosaminoglycans (GAGs) play an emerging leading role. When mother's milk is unavailable or in short supply, pasteurised donor milk represents an important nutritional alternative. The aim of this study was to evaluate the effect of Holder pasteurisation on the concentration of different GAGs in preterm human milk. METHODS:: Milk samples collected from 9 mothers having delivered preterm were divided into 2 parts. One part of each sample was immediately frozen (-80°C), whereas the other part was pasteurised with the Holder method before being frozen at -80°C. Specific analytical procedures were applied to evaluate the amount, composition, and structure of main human milk GAGs. RESULTS:: No significative differences were measured between not-treated and pasteurised samples for total GAGs content, relative percentages of chondroitin sulfate and heparan sulfate, and main parameters related to galactosaminoglycans structure, even if a slight decrease of total GAGs content of ∼18% was observed in treated samples. CONCLUSIONS:: Our results indicate that the Holder pasteurisation does not significatively affect the concentration of the main human milk GAGs. © 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Giribaldi M.,National Research Council Italy | Giribaldi M.,Food & Nutrition Research Center | Coscia A.,University of Turin | Peila C.,University of Turin | And 7 more authors.
Innovative Food Science and Emerging Technologies | Year: 2016

A new small-scale continuous-flow High-Temperature Short-Time (HTST) pasteurizer has been designed for treating human milk. The efficacy of the new HTST device was assessed on inoculated Listeria monocytogenes, Staphylococcus aureus and Chronobacter sakazakii, as well as on raw human milk bacteria. The milk biochemical quality after HTST pasteurization was assessed in comparison to a standard Holder pasteurization, by determining the secretory IgAs (sIgAs) content, the protein profile, lysozyme and the Bile Salt Stimulated Lipase (BSSL) activities. No pathogen or bacterial growth was detected after HTST pasteurization with the new instrument. Changes in the protein profile were observed in the milk pasteurized according to both processes. The sIgAs content and BSSL activity were significantly higher in the milk pasteurized with the new device than in the same milk treated by the standard Holder pasteurization. In conclusion, the new HTST apparatus: (i) can effectively pasteurize human milk with a better retention of sIgAs content and BSSL activity; (ii) comply to human milk banking safety requirements. Industrial relevance Currently, 210 active human milk banks are located in Europe (and 17 more are planned). The majority of the European banks still use Holder-based pasteurizers, which, despite efficacy in ensuring microbiological safety, are known to reduce/disrupt important nutritional and non-nutritional biological factors. Although already widely established in food industry, the advantages of HTST technology were tested only at small laboratory scale for human milk. The device tested in the present research was specifically designed to provide human milk banks with the technology they need to ensure a safe and lower-impact pasteurization process, that is suitable for processing different volumes of donations. The device can pasteurize up to 10 L of milk per hour, with a minimum volume of 100 mL. The system is designed to be cleaned-in-place (CIP) after each pasteurization run and sanitized immediately prior to the next use, being thus more suitable for treating pools of milk from different donors than milk from single donations. Italian and EU patents have been filed for the device, within a partnership between public research institutions, stakeholders (Italian association of donor milk banks), and a private company in the sector of dairy processing equipment. The device has achieved a Technology Readiness Level (TRL) 6 (Prototype demonstration in a relevant environment). The cost of the new device will be comparable to that of a typical human milk Holder pasteurizer. © 2016 Elsevier Ltd

De Nisi G.,Italian Association of Human Milk Banks
Journal of biological regulators and homeostatic agents | Year: 2012

In a NICU early enteral feeding is usually possible only when the newborn clinical conditions permit it. Because of the frequent need of umbilical/central catheters, they usually start with parenteral feeding and/or with minimal enteral feeding (trophic feeding). This kind of management is even more frequent in VLBWIs, in which the risk of NEC is very high. In this work we describe a model of early enteral exclusive feeding (EEEF) based on the use of banking human milk followed by mother milk. In the Centre of Neonatology of Trento, as in other Centers, the newborns weighing less than 750g or with a GE< 27 weeks, are treated with parenteral nutrition and minimal enteral feeding. The newborn weighing 750-1249g and with GE > 26 weeks define a group in which we find critical neonates, who can not be treated with enteral feeding, and neonates whose clinical conditions permit EEEF. In particular, in a period of 16 years (1994-2009) in Trento, 308 newborns weighing 750-1249 g and GE > than 26 weeks were admitted. The 90,9 % has been treated with prenatal steroids, the 91,9 % was inborn, the 96,1% survived. In the 59,1 % of the cases (175) we gave EEEF. We could continue with a complete EEEF in the 40,2 % of the total (119 cases). The characteristics of these neonates and our centre management, based mainly on early use of banking human milk and mother milk, are detailed described.

Arslanoglu S.,Italian Association of Human Milk Banks
Journal of biological regulators and homeostatic agents | Year: 2012

A mixture of neutral prebiotic oligosaccharides has been shown to reduce the incidence of atopic dermatitis (AD) and allergy associated symptoms during the first 2 years of life. To evaluate if this protective effect against allergy lasted beyond the intervention period until 5 y of age. In a prospective, double blind, placebo-controlled fashion, healthy term infants at risk of atopy were fed either a prebiotic-supplemented (0.8 g/100 ml scGOS/lcFOS) or placebo-supplemented (0.8 g/100 ml maltodextrin) hypoallergenic formula during the first 6 mo of life. Following this intervention period, follow-up continued until 5 y of life. The present study evaluated (i) the cumulative incidence of allergic manifestations during 5 y, and (ii) the prevalence of allergic and persistent allergic manifestations at 5 y. Monitored allergic manifestations were AD, recurrent wheezing, allergic rhinoconjunctivitis and urticaria. Ninety-two children (50 in placebo group, 42 in intervention group) completed the 5-y follow-up. The 5-y cumulative incidences of any allergic manifestation and atopic dermatitis were significantly lower in the scGOS/lcFOS group (30.9, 19.1 %, respectively) compared to placebo group (66, 38 %, respectively) (p< 0.01 and< 0.05). Children in the scGOS/lcFOS group tended to have a lower incidence of allergic rhinoconjunctivitis, and allergic urticaria (4.8 vs 16% for both manifestations, p=0.08). There was no difference in the cumulative incidence of recurrent wheezing. With regard to the prevalences at 5 y, intervention group had significantly lower prevalence of any persistent allergic manifestation and rhinoconjunctivitis (4.8, 2.4 %, respectively) compared to placebo (26, 14 %, respectively) (p < 0.01 and =0.05). Prevalence of persistent AD tended to be lower in the intervention group (2.4 vs 12%, p= 0.09). Although intervention group had 75% reduction in the prevalence of persistent wheezing (4.8 vs 14 %), no significance was shown. Oligosaccharide prebiotics (scGOS/lcFOS), when started early in life have a protective effect against allergic manifestations in high risk infants. The protection lasts beyond infancy until 5 y of life, for AD and allergic rhinoconjunctivitis. Long-term follow-up studies in larger populations are warranted to evaluate the potential preventive effect of this mixture on asthma.

Arslanoglu S.,Italian Association of Human Milk Banks | Corpeleijn W.,VU University Amsterdam | Moro G.,Italian Association of Human Milk Banks | Braegger C.,University of Zurich | And 11 more authors.
Journal of Pediatric Gastroenterology and Nutrition | Year: 2013

The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants. The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions for future research directions. Protection against necrotizing enterocolitis is the major clinical benefit deriving from the use of DHM when compared with formula. Limited data also suggest unfortified DHM to be associated with improved feeding tolerance and with reduced cardiovascular risk factors during adolescence. Presence of a human milk bank (HMB) does not decrease breast-feeding rates at discharge, but decreases the use of formula during the first weeks of life. This commentary emphasizes that fresh own motherÊs milk (OMM) is the first choice in preterm infant feeding and strong efforts should be made to promote lactation. When OMM is not available, DHM is the recommended alternative. When neither OMM nor DHM is available, preterm formula should be used. DHM should be provided from an established HMB, which follows specific safety guidelines. Storage and processing of human milk reduces some biological components, which may diminish its health benefits. From a nutritional point of view, DHM, like HM, does not meet the requirements of preterm infants, necessitating a specific fortification regimen to optimize growth. Future research should focus on the improvement of milk processing in HMB, particularly of heat treatment; on the optimization of HM fortification; and on further evaluation of the potential clinical benefits of processed and fortified DHM. Copyright © 2013 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

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