Talk:BGDB Gastrointestinal - Postnatal

BGD Internal Links 2009 6. Postnatal

Antiinfective properties of human milk

J Nutr. 2008 Sep;138(9):1801S-1806S.

Chirico G, Marzollo R, Cortinovis S, Fonte C, Gasparoni A.

Department of Neonatology and Neonatal Intensive Care, Spedali Civili, 25123 Brescia, Italy. gaechirico@alice.it Abstract The unfavorable effects of neonatal immunodeficiency are limited by some naturally occurring compensatory mechanisms, such as the introduction of protective and immunological components of human milk in the infant. Breast-feeding maintains the maternal-fetal immunological link after birth, may favor the transmission of immunocompetence from the mother to her infant, and is considered an important contributory factor to the neonatal immune defense system during a delicate and crucial period for immune development. Several studies have reported that breast-feeding, because of the antimicrobial activity against several viruses, bacteria, and protozoa, may reduce the incidence of infection in infants. The protection from infections may be ensured either passively by factors with antiinfective, hormonal, enzymatic, trophic, and bioactive activity present in breast milk, or through a modulator effect on the neonatal immune system exerted by cells, cytokines, and other immune agents in human milk.

PMID: 18716190 http://www.ncbi.nlm.nih.gov/pubmed/18716190

Reevaluation of the DHA requirement for the premature infant

Prostaglandins Leukot Essent Fatty Acids. 2009 Aug-Sep;81(2-3):143-50. Epub 2009 Jul 5

Lapillonne A, Jensen CL.

APHP, Paris Descartes University, Paris, France. alexandre.lapillonne@svp.aphp.fr

Abstract

The long-chain polyunsaturated fatty acid (LC-PUFA) intake in preterm infants is crucial for normal central nervous system development and has the potential for long-lasting effects that extend beyond the period of dietary insufficiency. While much attention has focused on improving their nutritional intake, many premature infants do not receive an adequate DHA supply. We demonstrate that enterally fed premature infants exhibit daily DHA deficit of 20mg/kg.d, representing 44% of the DHA that should have been accumulated. Furthermore, the DHA content of human milk and current preterm formulas cannot compensate for an early DHA deficit which may occur during the first month of life. We recommend breast-feeding, which supplies preformed LC-PUFA, as the preferred method of feeding for preterm infants. However, to fulfill the specific DHA requirement of these infants, we recommend increasing the DHA content of human milk either by providing the mothers with a DHA supplement or by adding DHA directly to the milk. Increasing the DHA content above 1% total fatty acids appears to be safe and may enhance neurological development particularly that of infants with a birth weight below 1250 g. We estimate that human milk and preterm formula should contain approximately 1.5% of fatty acid as DHA to prevent the appearance of a DHA deficit and to compensate for the early DHA deficit.

• LC-PUFA, particularly docosahexaenoic acid (DHA) and arachidonic acid (AA), accumulate rapidly during the brain growth spurt
• During the last trimester of pregnancy, the placenta provides the fetus with AA and DHA.
• highly concentrated in cell membranes of the retina and brain
• have important effects on membrane function, neurogenesis, photoreceptor differentiation, activation of the visual pigment rhodopsin, protection against oxidative stress, the activity of several enzymes, the function of ion channels, and the levels and metabolism of neurotransmitters and eicosanoids

PMID: 19577914 http://www.ncbi.nlm.nih.gov/pubmed/19577914