Cytomegalovirus in breast milk of Swedish milk donors

81 milk samples collected from 35 donors 3 days to 7 months after delivery were examined for the occurrence of cytomegalovirus (CMV). 30/35 (89%) of the women were seropositive to CMV. The virus was only found in samples from seropositive women collected greater than 8 days to less than 3 months after partus. During this period milk from 23 seropositive donors were tested; 16/23 (70%) excreted CMV. CMV is evidently a very common finding in the milk of seropositive mothers.     

Epstein-Barr virus shedding in breast milk.

One hundred healthy women already donating to the Children's Hospital Breast Milk bank consented to provide a sample of breast milk for this study. Using a DNA-DNA hybridization dot-blot assay Epstein-Barr virus (EBV) genome (Bam HIW region) was detected in cells shed into breast milk of 46 out of 100 women studied and in 60 out of 132 (46%) of samples donated overall. The prevalence of EBV shedding increased postnatally to a peak of 74% (26/35 positive samples) between 3 and 12 weeks postdelivery. Women delivering prematurely had an initially lower prevalence of shedding with only six out of 30 (20%) positive samples in the first week after delivery, compared to 16 out of 35 (46%) for women delivering at term. Of the 18 women donating more than one sample, 13 showed consistently positive (n = 8) or negative (n = 5) results, and the remaining five had intermittent shedding detected. Only seven out of 42 (17%) breast milk samples studied were EBV-IgG antibody positive, and none showed IgM or IgA-EBV antibodies. Further studies and prospective followup of infants are needed to confirm that breast milk is a significant source for early EBV infection of infants, as indicated by serologic studies.     

Thrombospondin in milk, other breast secretions, and breast tissue

Colostrum and milk contained high concentrations of thrombospondin, although the concentration relative to total protein content decreased as lactation was established. Thrombospondin occurred in the aqueous phase of milk rather than as a component of the milk fat globule membrane. It could be purified from colostrum using established procedures after removal of lipid from the starting material. The intact protein had a molecular weight of 450 kd, but the product contained small peptides, perhaps as a result of proteolytic activity in the colostrum. Thrombospondin from goat colostrum displayed a different proteolytic fragmentation pattern from thrombospondins isolated from three human sources, but this could be a species- rather than tissue-specific difference. Breast cancer cytosols contained significantly more thrombospondin than cytosols from normal tissue or benign dysplasias. Thrombospondin levels in a variety of breast secretions all fell within the range found in colostrum and milk, as did the fluids from Na+ (group II) breast cysts. K+ (group I) cysts, however, contained fluids with low thrombospondin concentrations, eliminating apocrine cells as the source of thrombospondin in the breast.     

Post-weaning breast milk HIV-1 viral load, blood prolactin levels and breast milk volume

BACKGROUND: The effect of abrupt weaning, advocated as a safe transition from exclusive breastfeeding in HIV-exposed children, on the quantity of HIV viral load in breast milk (BMVL) is not known. OBJECTIVES: To determine the effect of abrupt cessation of breastfeeding on serum prolactin, pumped breast milk volume and BMVL obtained 2 weeks after rapid weaning in HIV-infected women. METHODS: Women enrolled in a prospective study (ZEBS) were randomized to abruptly wean at 20 weeks postpartum or continue exclusive breastfeeding. Breast milk was obtained at 22 weeks by electric breast pump over 10 min from 222 women who had either weaned or continued to breastfeed. Pre- and post-pumping prolactin was measured. BMVL was measured at 20 and 22 weeks in 71 randomly selected women from both groups. RESULTS: Baseline prolactin and breast milk volume was significantly lower among women who had weaned. Detectable (68 versus 42%; P = 0.03) and median BMVL (448 versus < 50 copies/ml; P = 0.005) was significantly higher among those who had weaned in comparison with those who were still breastfeeding and was significantly higher in the same women after weaning compared with 2 weeks earlier (P = 0.001). CONCLUSIONS: BMVL is substantially higher after rapid weaning and this may pose an increased risk of HIV transmission if children resume breastfeeding after a period of cessation. Increases in BMVL with differing degrees of mixed feeding needs to be assessed.     

Propranolol in human plasma and breast milk.

To assess the problem of continuing propranolol therapy in a breast-feeding mother, studies were performed to determine simultaneously plasma and breast milk concentrations of propranolol after single dose (40 mg) and continuous dose (40 mg 4 times daily) treatment with this drug. Breast milk and plasma concentrations of propranolol peaked between 2 and 3 hours after dosing. Propranolol concentrations in breast milk were less than 40 and 64 percent, respectively, of peak plasma propranolol concentrations after single dose and continuous dose administration. It was estimated that the maximal cumulative propranolol load to this breast-feeding infant, consuming 500 ml of whole milk, when the mother received 40 mg of propranolol 4 times daily would be 21 microgram/24 hours. This dose is considerably less than the usual therapeutic dose of propranolol for infants.     

Leukocytes in expressed breast milk of asthmatic mothers

ObjectiveInfants are born immunologically immature. However, breastfeeding mothers retain an immunological link to their infants. While it is generally accepted that infants are at an immunological advantage when compared with formula-fed infants, the benefit of long-term exclusive breastfeeding by atopic mothers remains controversial. Inconsistency in the conferral of benefit may be due to differences in the immunological constituents passed to the recipient infant. The aim of this investigation was to examine the profile of human milk cells and cytokines from asthmatic compared to non-asthmatic mothers.MethodsTwenty-five exclusively breastfeeding mothers with a clinical diagnosis of asthma were postpartum age matched in a double-control 2:1 design with 50 non-asthmatic controls. Each mother provided a single milk sample which was assayed for cell differential by flow cytometry, for ex vivo cytokine production in culture and for aqueous phase cytokines.ResultsMilks from asthmatic mothers differed from non-asthmatics in that they contained a higher proportion of polymorphonuclear (PMN) cells and lower proportion of lymphocytes, predominantly CD3⁺/CD4⁺ T helper cells, reflected by a decrease in the chemokine CCL5 in the milk aqueous phase. More PMN and lymphocytes from asthmatic mothers expressed the adhesion molecule CD11b and lymphocytes the IgE receptor CD23, than those from non-asthmatic mothers.ConclusionsChanges to human milk leucocyte prevalence, activation state and cytokines due to maternal asthma may result in changes to immunological priming in the infant. Consequently, the protective effect of long-term breastfeeding may be altered in these mother-infant pairs.     

Imatinib mesylate

Imatinib is an example of a new group of drugs being developed using the principle of molecular targeting. Imatinib is able to kill the cancer cells and not the body's healthy cells. Imatinib mesylate is indicated for the treatment of patients with Kit (CD117)-positive unresectable and/or metastatic malignant gastrointestinal stromal tumors and patients with Philadelphia chromosome-positive chronic myeloid leukemia in blast crisis, accelerated phase, or in chronic phase after failure of interferon-alfa.     

Impact of chloroquine on viral load in breast milk

The anti-malarial agent chloroquine has activity against HIV. We compared the effect of chloroquine (n = 18) to an anti-malarial agent without known anti-HIV-activity, sulfadoxine-pyrimethamine (n = 12), on breast milk HIV RNA levels among HIV-infected breastfeeding women in Zambia. After adjusting for CD4 count and plasma viral load, chloroquine was associated with a trend towards lower levels of HIV RNA in breast milk compared with sulfadoxine-pyrimethamine (P = 0.05). Higher breastmilk viral load was also observed among women receiving presumptive treatment for symptomatic malaria compared with asymptomatic controls and among controls reporting fever in the prior week. Further research is needed to determine the potential role of chloroquine in prevention of HIV transmission through breastfeeding.     

Assay of ghrelin concentration in infant formulas and breast milk

AIM: To test if total ghrelin is present in infant formulas. METHODS: Using a radioimmunoassay, we measured total ghrelin concentrations in 19 samples of commercial infant formulas and in 20 samples of human milk. We also determined ghrelin concentration in the serum of infants and lactating mothers. RESULTS: Ghrelin concentrations were significantly higher in artificial milk (2007.1 ± 1725.36 pg/mL) than in human milk (828.17 ± 323.32 pg/mL) (P = 0.005). The mean ghrelin concentration in infant serum (n = ...     

Influence of breast milk on nosocomial rotavirus infections in infants

Summary To prevent nosocomial rotavirus infections in hospitalized children with various non-gastrointestinal diseases, 30 children (mean age five months) received 200 ml of fresh human milk per day in addition to the normal diet for their age. A matched group of children on formula diet served as a control. Fecal samples were routinely screened for rotavirus by a commercial ELISA test. In stools containing rotavirus, the virus RNA segments were analysed by gel electrophoresis to identify the different rotavirus strains. Clinical symptoms were recorded daily and quantified by a score system. Human milk had no effect on the frequency of nosocomial rotavirus infections: ten infected children were fed with human milk and seven were not. However, the severity of the clinical symptoms was clearly reduced: the mean score of clinical symptoms was only half as great and the number of mild or asymptomatic infections was doubled in the group receiving fresh human milk.

---

Einfluß von Frauenmilch auf nosocomiale Rotavirusinfektionen bei Säuglingen

Zusammenfassung Mit dem Ziel einer Verhütung von nosocomialen Rotavirusinfektionen bei Kindern, die wegen nicht gastrointestinaler Erkrankungen hospitalisiert wurden, erhielt eine Gruppe von 30 Kindern (mittleres Alter fünf Monate) 200 ml frische Frauenmilch als Zusatz zu ihrer altersgemäßen Ernährung. Eine Kontrollgruppe von Kindern wurde ohne Frauenmilch ernährt. Stuhlproben wurden mit einem kommerziell erhältlichen ELISA Test regelmäßig auf Rotaviren untersucht. In positiven Stuhlproben wurden die Virus RNA-Segmente mittels Gelelektrophorese untersucht und die verschiedenen Typen von Rotavirus identifiziert. Die klinischen Symptome wurden täglich aufgezeichnet und mittels eines Bewertungssystems quantifiziert. Frauenmilch hatte keinen Effekt auf die Häufigkeit von nosocomialen Rotavirusinfektionen. Zehn der infizierten Kinder wurden mit Frauenmilch gefüttert, sieben nicht. Die Schwere der klinischen Symptome war jedoch deutlich reduziert: die Bewertungszahl der Symptome war halb, und die Zahl der asymptomatischen oder mild verlaufenden Infektionen doppelt so hoch bei der Gruppe von Kindern, die Frauenmilch erhalten hatten.