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      Características y motivaciones de las mujeres donantes del banco de leche en el Complejo Asistencial Dr. Sótero del Río Translated title: Characteristics and motivations of donors to the human milk ba nk in Dr. Sótero del Rio Hospital, Chile

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          Abstract

          RESUMEN El propósito de este trabajo fue describir las características, motivaciones, barreras y fuentes de información de las mujeres donantes del Banco de Leche en el Complejo Asistencial Dr. Sótero del Río (CASR). Método: El diseño utilizado en este estudio correspondió a uno de tipo transversal descriptivo. Se realizó una encuesta telefónica con 15 preguntas a 82 mujeres que fueron donantes en al menos una oportunidad en el banco de leche del CASR desde el año 2015 a septiembre de 2017. Se estimaron proporciones para las variables categóricas y medidas de tendencia central y de dispersión para la edad Se calcularon intervalos de confianza al 95%. Resultados: La edad media de las donantes fue de 31,3 años con una desviación estándar de 4,6. El 92,7% se encontraba casada o en convivencia y un 58,5% (IC 95% 47,1 – 69,3) cursó educación profesional superior completa. La principal motivación para donar fue la empatia (41,5% [IC 95% 30,7 – 52,9]) y las principales fuentes de conocimiento fueron internet/redes sociales 43,9% (IC 95% 33,0 – 55,3) y personal de salud 32% (IC 95% 22,9 – 44,2). Conclusiones: La mujer donante del banco de leche del CASR, se encuentra principalmente casada o en convivencia, posee un alto nivel educacional y trabaja fuera del hogar. Estos resultados podrían orientar estrategias al fortalecimiento del banco de leche.

          Translated abstract

          ABSTRACT This study sought to describe characteristics, motivations, barriers, and sources of information of human milk donors to the milk bank at Dr. Sótero del Río Hospital, Chile. Methods: A descriptive and cross - sectional study was carried out. We conducted a 15-question telephone survey in 82 women who were at least one-time milk donors between 2015 and 2017. Statistical analysis included frequencies and percentages for categorical variables and measures of central tendency and dispersion for quantitative variables. We calculated 95% confidence intervals (CI). Results: The mean age of donors was 31.34,6 years; 92.7% were married or were living with their partner and 58.5% (95% CI of 47.1– 69.3) had completed higher education. The main motivation for donating was helping others (41.5% [95% CI of 30.7– 52.9]). The primary sources of knowledge on milk donations were the internet and social networks (43.9% [IC 95% 33.0– 55.3]), followed by health personnel 32% (95% CI of 22.9– 44.2). Conclusions: The donor profile in CASR's milk bank is a young woman, with a stable partner and high educational level. These results could provide useful information to improve strategies for human milk donation.

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          Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age.

          Beneficial effects of breast milk on cognitive skills and behavior ratings have been demonstrated previously in term and very low birth weight infants. Extremely low birth weight infants are known to be at increased risk for developmental and behavior morbidities. The benefits of breast milk that is ingested in the NICU by extremely low birth weight infants on development and behavior have not been evaluated previously. Nutrition data including enteral and parenteral feeds were collected prospectively, and follow-up assessments of 1035 extremely low birth weight infants at 18 months' corrected age were completed at 15 sites that were participants in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial between October 14, 1999, and June 25, 2001. Total volume of breast milk feeds (mL/kg per day) during hospitalization was calculated. Neonatal characteristics and morbidities, interim history, and neurodevelopmental and growth outcomes at 18 to 22 months' corrected age were assessed. There were 775 (74.9%) infants in the breast milk and 260 (25.1%) infants in the no breast milk group. Infants in the breast milk group were similar to those in the no breast milk group in every neonatal characteristic and morbidity, including number of days of hospitalization. Mean age of first day of breast milk for the breast milk infants was 9.3 +/- 9 days. Infants in the breast milk group began to ingest non-breast milk formula later (22.8 vs 7.3 days) compared with the non-breast milk group. Age at achieving full enteral feeds was similar between the breast milk and non-breast milk groups (29.0 +/- 18 vs 27.4 +/- 15). Energy intakes of 107.5 kg/day and 105.9 kg/day during the hospitalization did not differ between the breast milk and non-breast milk groups, respectively. At discharge, 30.6% of infants in the breast milk group still were receiving breast milk. Mothers in the breast milk group were significantly more likely to be white (42% vs 27%), be married (50% vs 30%), have a college degree (22% vs 6%), and have private health insurance (34% vs 18%) compared with the no breast milk group. Mothers who were black, had a low household income ( or = 85, higher mean Bayley Psychomotor Development Index, and higher Bayley Behavior Rating Scale percentile scores for orientation/engagement, motor regulation, and total score. There were no differences in the rates of moderate to severe cerebral palsy or blindness or hearing impairment between the 2 study groups. There were no differences in the mean weight (10.4 kg vs 10.4 kg), length (80.5 cm vs 80.5 cm), or head circumference (46.8 cm vs 46.6 cm) for the breast milk and no breast milk groups, respectively, at 18 months. Multivariate analyses, adjusting for confounders, confirmed a significant independent association of breast milk on all 4 primary outcomes: the mean Bayley (Mental Development Index, Psychomotor Development Index, Behavior Rating Scale, and incidence of rehospitalization). For every 10-mL/kg per day increase in breast milk ingestion, the Mental Development Index increased by 0.53 points, the Psychomotor Development Index increased by 0.63 points, the Behavior Rating Scale percentile score increased by 0.82 points, and the likelihood of rehospitalization decreased by 6%. In an effort to identify a threshold effect of breast milk on Bayley Mental Development Index and Psychomotor Development Index scores and Behavior Rating Scale percentile scores, the mean volume of breast milk per kilogram per day during the hospitalization was calculated, and infants in the breast milk group were divided into quintiles of breast milk ingestion adjusted for confounders. Overall, the differences across the feeding quintiles of Mental Development Index and Psychomotor Development Index were significant. There was a 14.0% difference in Behavior Rating Scale scores between the lowest and highest quintiles. For the outcomes (Mental Development Index, Psychomotor Development Index, Behavior Rating Scale, and Rehospitalization 80th percentile quintile of breast milk feeding were significantly different from the no breast milk values. In our adjusted regression analyses, every 10 mL/kg per day breast milk contributed 0.53 points to the Bayley Mental Development Index; therefore, the impact of breast milk ingestion during the hospitalization for infants in the highest quintile (110 mL/kg per day) on the Bayley Mental Development Index would be 10 x 0.53, or 5.3 points. An increase of 5 points potentially would optimize outcomes and decrease costs by decreasing the number of very low birth weight children who require special education services. The societal implications of a 5-point potential difference (one third of an SD) in IQ are substantial. The potential long-term benefit of receiving breast milk in the NICU for extremely low birth weight infants may be to optimize cognitive potential and reduce the need for early intervention and special education services.
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            Preterm milk oligosaccharides during the first month of lactation.

            Oligosaccharides represent one of the main components of human milk, and they have been assigned important biological functions for newborns. Qualitatively and quantitatively, their presence in milk is strictly related to the expression of the mother's Se and/or Le genes, on the basis of which 4 different milk groups have been described. The aim of the study was to provide new data on the oligosaccharide composition of preterm milk in relation to the 4 groups. High-pH anion-exchange chromatography was used to quantify levels of 23 oligosaccharides and lactose in 252 milk samples collected from 63 mothers during the first month of lactation and to identify the 4 milk groups. Substantial differences in oligosaccharide contents were found within the groups and were strictly related to the presence or absence of specific fucosyl-oligosaccharides. The highest concentration was found in group 1 (>20 g/L), the lowest level was found in group 4 (∼10 g/L), and intermediate values were observed in groups 2 and 3. No statistically significant differences in lactose concentrations were observed among the groups. Our data confirm lower lactose concentrations in preterm milk, compared with term milk, and they provide the first detailed characterization of oligosaccharides in preterm milk, demonstrating important differences in oligosaccharide contents in the 4 groups. These differences might exert an influence on several biological functions that are particularly important for preterm infants and currently are attributed to milk oligosaccharides.
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              Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis.

              To compare the effect of donor breast milk with infant formula in preterm infants. Separate comparisons with formula were made for donor breast milk that was: (1) given as a sole diet; (2) given as a supplement to mother's own breast milk; and (3) fortified with macronutrients and micronutrients. The main outcomes were death, necrotising enterocolitis (NEC), infection, growth and development. Electronic databases-Cochrane, CENTRAL, MEDLINE, EMBASE, CINAHL, and HMIC: DH. Systematic review and meta-analysis of trials and observational studies of preterm or low birthweight infants. Seven studies (including five randomised controlled trials), all from the 1970s and 1980s, fulfilled the inclusion criteria. All studies compared the effect of sole donor breast milk with formula (combined n = 471). One of these also compared the effect of donor breast milk with formula given as a supplement to mother's own milk (n = 343). No studies examined fortified donor breast milk. A meta-analysis based on three studies found a lower risk of NEC in infants receiving donor breast milk compared with formula (combined RR 0.21, 95% CI 0.06 to 0.76). Donor breast milk was associated with slower growth in the early postnatal period, but its long-term effect is unclear. Donor breast milk is associated with a lower risk of NEC and slower growth in the early postnatal period, but the quality of the evidence is limited. Further research is needed to confirm these findings and measure the effect of fortified or supplemented donor breast milk.
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                Author and article information

                Journal
                rchnut
                Revista chilena de nutrición
                Rev. chil. nutr.
                Sociedad Chilena de Nutrición, Bromatología y Toxicología (Santiago, , Chile )
                0717-7518
                February 2020
                : 47
                : 1
                : 105-113
                Affiliations
                [1] Santiago Santiago de Chile orgnameUniversidad Mayor orgdiv1Facultad de Ciencias orgdiv2Escuela de Obstetricia y Puericultura Chile
                Article
                S0717-75182020000100105 S0717-7518(20)04700100105
                5103ae60-4558-4536-a531-b8ac319e7167

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 06 August 2019
                : 30 April 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 9
                Product

                SciELO Chile

                Categories
                ARTÍCULOS ORIGINALES

                Human milk-bank,Banco de leche humana,Donor-milk,Nutrición,Nutrition,Prematuros,Premature- infant,Neonatal intensive care unit,Donantes de leche,Unidad de cuidados intensivos neonatales

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