母乳保护早产儿肠道

Nature Medicine 2019-06-17发表的一项研究称,母乳中的抗体可以中和细菌,从而保护早产儿的肠道。将近10%早产儿会发生坏死性小肠结肠炎,这是一种由细菌引起的疾病,可能导致严重的炎性反应和肠壁破坏,是早产儿第二常见的死亡原因。新的研究发现,母乳中的抗体可以中和细菌,保护早产儿的肠道。然而有些母亲的母乳不够,可能选择捐赠的母乳,但并非所有母乳都含有抗体。研究建议应对捐赠母乳进行测试,确保早产儿可以获得最好的保护。     

断母乳后乳制品的添加与生长发育的关系

为了解小儿在断母乳后制品的添加情况与生长发育的关系，本文以秀城区范围内在１９９６年到１９９８年出生的小儿中，随机抽取４９０人，他们均在６月－１２月间断母乳，根据断奶以后的乳制品情况分为Ａ、Ｂ、Ｃ３组，对每组在６月和１２月时的体重进行了监测，并进行了增重均值的比较。结果表明乳制品添加多少与小儿的生长发育密切相关。提示断母乳后合理地添加乳制品有利于小儿的生长发育。     

婴幼儿轮状病毒肠炎与母乳轮状病毒感染关系的研究

目的通过测定母乳中RV研究乳母感染RV与婴幼儿RV肠炎的关系。方法收集确诊RV肠炎婴幼儿母亲母乳测定RV抗原;另收集健康婴幼儿母亲母乳测定RV抗原。RV检测:采用ELISA法。结果共进行检查RV性肠炎婴幼儿及其母亲共213对,婴幼儿年龄1个月~2岁。其中母亲乳汁RV抗原阳性者162例,占76.06%。同时设对照组:婴幼儿年龄1个月~2岁,无消化道症状,母乳喂养,查母亲乳汁RV抗原共50例,母亲乳汁RV抗原阳性者2例,占4%。|u|=9.36>2.58,P<0.01差别有高度统计意义[1]。结论母亲感染RV可能通过乳汁传染给自己的婴幼儿使其患RV肠炎。     

肝酶诱导剂治疗母乳性黄疸综合征的临床观察

为探讨肝酶诱导剂对母乳性黄疸综合征的疗效及暂停母乳对母婴的身心影响,本文进行了分组疗效比较及暂停母乳喂养相关的问卷调查,结果显示:应用肝酶诱导剂不停母乳与暂停母乳均能获得良好的疗效(P>0.05)。暂停母乳喂养对母婴有程度不等的身心影响。本文认为母乳性黄疸综合征可以肝酶诱导剂疗法代替暂停母乳喂养疗法。     

婴儿母乳性黄疸血清甲状腺激素观察

我们对２０例母乳性黄疸的婴儿进行甲状腺激素的测定，以观察母乳性黄疸血清甲状腺激素的变化；结果发现；ＢＭＪ患儿血清Ｔ３下降明显，与对照组比较，两组比较差异具有显著性，而Ｔ４，ＴＳＨ两组比较其差异均无显著性。     

母乳中铁蛋白含量的观察

婴幼儿正常发育有赖于合理的喂养。母乳是婴儿，尤其是婴幼儿最理想的食品。为了了解不同哺乳期母乳或混合喂养儿母乳中铁蛋白的含量，我们采用放射免疫分析法(RIA)对初乳及其以后时期的母乳铁蛋白水平做了测定，其结果初步总结于下。     

尿β2-微球蛋白在母乳性黄疸患儿早期肾功能损害诊断中的价值

目的 探讨尿β2-微球蛋白(β2-MG)检测在母乳性黄痘早期肾功能损害诊断中的价值。方法 对87例母乳性黄疸患儿，采用放射免疫法，测定其尿β2-MG的含量，并对结果与正常新生儿进行时比分析。结果 母乳性黄痘患儿胆红素越高，尿β2-MG的值也越高，肾功能损害存在的可能性也越大。结论 尿β2-MG检测可作为母乳性黄痘早期肾功能损害的检测方法；对母乳性黄痘早期肾功能损害的诊断有一定临床价值。     

荧光定量PCR法检测母乳巨细胞病毒感染和母婴传播

目的了解母乳人巨细胞病毒（HCMV）感染状况和母婴传播情况.方法应用荧光定量PCR（FQ-PCR）法检测390份母乳中HCMV-DNA含量,其中236份母乳配对与患儿血液或尿液中HCMV-DNA含量作一定分析.结果可疑或确诊HCMV感染患儿母亲母乳HCMV-DNA阳性率达71.28%,HCMV-DNA阳性母乳喂养的婴儿,其血或尿HCMV-DNA阳性率明显高于HCMV-DNA阴性母乳喂养的婴儿.结论HCMV感染母乳是婴儿获得性感染的主要途径.     

南京市区170例母乳铅与母血、脐血铅含量的相关性分析

目的了解南京地区产妇母乳含量与母血、脐血铅含量之间的相关性。方法采用石墨炉原子吸收光谱法对南京地区170例产妇抽取母乳与母血、脐血中铅含量进行测定,并进行三者之间的相关性分析。结果母血铅含量为14.87-121μg/L,均值为69μg/L;铅含量为15.42-114.32均值为48.74;母乳铅含量为12.42-99.36μg/L,均值为50.23μg/L。母血铅/脐血铅含量呈正相关（r=0.398,P〈0.05）;母血铅/初乳铅含量呈正相关（r=0.571,P〈0.01）;乳铅/脐血铅含量呈正相关（r=0.489,P〈0.05）。结论脐血铅含量呈正相关,血铅可通过胎盘转运给胎儿,母血铅含量与脐血铅水平及母乳铅水平受母血铅含量影响。     

51例早发型母乳性黄疸临床分析

51例早发型母乳性黄疸婴儿均为母乳喂养的足月新生儿。根据黄疸程度不同及皮测胆红素轻重情况,5例胆红素较高者给予停母乳加光疗,29例暂停母乳1－3天,17例给予少量多次母乳,3天以后婴儿黄疸均下降50％以上。早发型母乳性黄疸是由于胆红素的肠肝循环增加而引起。肠肝循环增加的原因主要由于初乳中β－葡萄糖醛酸苷酶（β－GD）活性增高,其次与热量摄入不足有关。故认为刚出生1－3天的新生儿在母乳不充足情况下用小勺喂给婴儿适量葡萄糖水、奶粉（杜绝用奶瓶、奶嘴以兔使婴儿产生错觉,影响日后母乳喂养）以补充热量,刺激肠蠕动,加速胆红素排泄,减少胆红素的重吸收,从而减少早发型母乳性黄疸的发生。     

母乳性黄疸对远期智能的影响

目的研究无高危因素的小儿母乳性黄疸对远期智能影响,指导母乳性黄疸的临床治疗。方法无高危因素的母乳性黄疸60例,分两组,一组29例,停母乳喂养,改人工喂养,记录黄疸消退时间;一组31例,予停母乳喂养,改人工喂养,以光疗,口服辅助药物等综合治疗;再取无高胆红素血症的对照组45例。3组小儿相同的随访和早教,一岁时由专业人员做婴儿智能测试,用CDCC量表测定智力发育指数(MDI)和运动发育指数(PDI)。结果 3组小儿在一岁时的智能无显著差异,无一例显示语言听力异常。结论无高危因素的母乳性黄疸对远期智能影响不大,可以适当放宽因黄疸而治疗的指征。     

Transmission of cytomegalovirus via breast milk to the prematurely born infant: a systematic review

To analyse current data on transmission of human cytomegalovirus (HCMV) via breast milk with subsequent symptomatic HCMV infection of the preterm infant and to report on long-term follow-up, a systematic literature review was performed using EMBASE, MEDLINE and CINAHL (January 1966 to December 2008) Studies were included for analysis if congenital HCMV infection was excluded and transmission via breast milk was either confirmed or strongly suspected. Twenty-six studies were included for analysis. Maternal HCMV-IgG-positivity was reported to be in the range 51.6–100% (median 81.6%), HCMV-IgG detection in breast milk in the range 67–97.2% (median 80%) and HCMV-positivity of the infants in the range 5.7–58.6%. Symptomatic HCMV disease occurred in 0–34.5% (median 3.7%) and severe sepsis-like syndrome in 0–13.8% (median 0.7%). Data on long-term outcome of preterm infants with symptomatic HCMV infection revealed a low risk for mild neurological and cognitive sequelae, without hearing impairment. Recommendations for high-risk preterm infants diverged markedly. The current data report low rates of symptomatic disease after transmission of HCMV via breast milk to the preterm infant without evidence of certain long-term sequelae. The results of our review do not support a general approach, either by avoidance or pasteurization of breast milk, in high-risk preterm infants.     

妈咪爱联合思密达治疗母乳性黄疸疗效观察

目的:观察妈咪爱联合思密达对降低母乳性黄疸患儿的血清胆红素的作用以及疗程的影响。方法:将198例母乳性黄疸患儿随机分为对照组和治疗组两组。对照组给以常规治疗,治疗组在常规治疗的基础上加用妈咪爱和思密达口服。结果:治疗组治疗后血清胆红素为69.04±11.17μmol.L-1,对照组为92.10±14.76μmol.L-1,两组相比有显著性差异(P<0.01)。显效与治愈天数:治疗组57例显效,且治愈天数为4.7±1.4d,而对照组仅21例显效,且治愈天数为10.4±1.9d,两组相比均有显著性差异(P<0.01)。结论:妈咪爱联合思密达辅助治疗母乳性黄疸有明显效果,经济方便,无严重不良反应,值得推广。     

Allopurinol and oxypurinol in human breast milk

Summary To pregnant or breast feeding women drugs should be given with caution. We report the case of a 5-week-old breast-fed infant whose mother was taking 300 mg allopurinol/day for 4 weeks. Allopurinol and oxypurinol were detected by HPLC in maternal plasma and breast milk with a method first described here. In infant's plasma taken 2 h after breast feeding oxypurinol was found; allopurinol was below the limit of detection. The milk/plasma ratio in the mother 2 h (4 h) after drug ingestion was 0.9 (1.4) for allopurinol and 3.9 (2.4) for oxypurinol. The average daily dose for the baby of allopurinol was 0.14–0.20 mg/kg and that of oxypurinol 7.2–8.0 mg/kg by ingestion of breast milk after oral intake of allopurinol by the mother.Dedicated to Prof. Dr. N. Zöllner on the occasion of his 70th birthday     

Transient heating of expressed breast milk up to 65°C inactivates HIV‐1 in milk: A simple,rapid, and cost‐effective method to prevent postnatal transmission

The postnatal transmission of human immunodeficiency virus (HIV) from mothers to children occurs through breastfeeding. Although heat treatment of expressed breast milk is a promising approach to make breastfeeding safer, it is still not popular, mainly because the recommended procedures are difficult to follow, or time‐consuming, or because mothers do not know which temperature is sufficient to inactivate HIV without destroying the nutritional elements of milk. To overcome these drawbacks, a simple and rapid method of heat treatment that a mother could perform with regular household materials applying her day‐to‐day art of cooking was examined. This structured experiment has demonstrated that both cell‐free and cell‐associated HIV type 1 (HIV‐1) in expressed breast milk could be inactivated once the temperature of milk reached 65°C. Furthermore, a heating method as simple as heating the milk in a pan over a stove to 65°C inhibited HIV‐1 transmission retaining milk's nutritional key elements, for example, total protein, IgG, IgA, and vitamin B₁₂. This study has highlighted a simple, handy, and cost‐effective method of heat treatment of expressed breast milk that mothers infected with HIV could apply easily and with more confidence. J. Med. Virol. 85:187–193, 2013. © 2012 Wiley Periodicals, Inc.     

Defective tumour necrosis factor-alpha production in mother''s milk is related to cow''s milk allergy in suckling infants

BACKGROUND: The precise role of leucocytes in human milk is still unresolved. OBJECTIVE: To assist in clarifying the immune mechanisms involved in the development of CMA in suckling infants, we studied the role of immunoregulatory leucocytes and their mediators in human breast milk. METHODS: The study population consisted of 43 lactating mothers and their infants, aged 0.25-8.0 months, followed-up prospectively from birth. Of these mothers, 27 had an infant with challenge-proven cow's milk allergy manifested with either skin (n = 23), gastrointestinal (n = 2) or skin and gastrointestinal symptoms (n = 3). Sixteen mothers with a healthy infant served as controls. We evaluated the spontaneous and mitogen-induced tumour necrosis factor-alpha (TNFalpha) and interferon-gamma (IFNgamma) production of human milk leucocytes and isolated peripheral blood lymphocytes in vitro with a commercial ELISA kit. RESULTS: TNFalpha production of breast milk leucocytes was significantly lower in the mothers with a cow's milk-allergic infant, whereas IFNgamma production of these cells was comparable in the two groups. CONCLUSION: Our results suggest that in the breast milk of mothers having an infant with cow's milk allergy, the number and function of TNFalpha-producing cells is defective. This might lead to a disturbance in the development of oral tolerance and thereby to the development of CMA in suckling infants. These novel results may help in clarifying the etiopathogenesis of CMA.     

Diversity of HIV-1 RNA and DNA in breast milk from HIV-1-infected mothers

We compared human immunodeficiency virus type 1 (HIV-1) RNA and DNA populations in the different fractions of breast milk (lactoserum, lipid layer, cell pellet) and between right and left breasts in four HIV-1-infected mothers by analyzing the hypervariable env C2-V5 region. Phylogenetic analyses of the viral quasispecies revealed that RNA populations and DNA populations were clearly distinct and that viral RNA sequences were similar in lipid layer and lactoserum in the milk of 3 out of 4 mothers. Comparison of viral DNA between milk from right and left breast showed a differential distribution of variants in three mothers. In contrast, RNA variants detected from milk of the two breasts were mixed in 3 out of 4 mothers. This study suggests that each mammary gland is subjected to microenvironmental pressure that may differ from the contralateral breast.     

Predictors of Inflammatory Breast Diseases During Lactation – Results of a Cohort Study

Problem  Inflammatory breast diseases during lactation are major reasons for early weaning.
Method of study  A prospective cohort study was performed to examine the association between stress and inflammatory breast diseases. Psychometric data, cytokine levels in breast milk and blood samples were analysed postpartum (T1). Psychometric data and course of breast feeding were evaluated twelve weeks later (T2). Patients were divided into case- and control-groups (according to the presence of breast diseases).
Results  Mothers of the case group ( n  = 23) were significantly older and showed significantly increased stress levels between T1 and T2 compared with the control group ( n  = 43). Leucocytes in the postpartum blood count were significantly decreased in the case group. There were no significant differences between groups in the concentrations of Th-1- and Th-2-cytokines in breast milk postpartum.
Conclusion  Higher maternal age, postpartum increase in stress perception and low number of leucocytes are associated with a higher incidence of inflammatory breast diseases. Further studies must examine the causality of this effect.     

Effects of milk fermented by Lactobacillus helveticus R389 on immune cells associated to mammary glands in normal and a breast cancer model

Antitumour activity is an effect attributed to probiotics and fermented foods. Here, the immune cells in mammary glands and cytokine concentration in serum were analyzed using mice fed with milk fermented by Lactobacillus helveticus R389 or L89 (proteolytic-deficient variant), injected or not with breast tumour cells. Mice were fed 7 days with fermented milk, injected with breast tumour cells and 4 days post-injection, they received fermented milk. IgA, CD4, CD8, cytokines and Bcl-2 positive cells in mammary glands and cytokine in serum were determined. Mice fed with L. helveticus R389 fermented milk and injected with tumour cells increased IgA and CD4 positive cells in mammary glands (tumour control increased CD8 + cells). Mice from fermented milk control groups (without tumour cell injection) did not show changes in immune cell or cytokine positive cell numbers. IL-10 increases and IL-6 decreases were more pronounced in mice fed with milk fermented by L. helveticus R389 than in the other groups. This study demonstrated the immunoregulatory capacity of milk fermented by L. helveticus R389 on the immune response in mammary glands in presence of a local pathology (breast tumour). Orally administered fermented products could be used to modify the immune cell activation in distant mucosal sites and maintain these cells alert, but local stimulus was necessary to produce the activation of a local immune response in mammary glands, which could modulate the immune-endocrine relationship in these glands.