Se evaluaron los efectos de formulas infantiles suplementadas con poliaminas y con fructooligosacaridos a dosis fisiológicas, sobre la maduración intestinal en lechones destetados precozmente. Se alimentaron 40 cerdos neonatales con leche materna, fórmula control, fórmula suplementada con poliaminas (5 nmol/ml espermina y 20 nmol/ml espermidina) y fórmula suplementada con FOS (8 g/l) (n=10/grupo experimental) durante un periodo de 13 días (del día 2 al 15 postparto). Nuestros resultados mostraron un aumento significativo en la profundidad de las criptas a nivel de yeyuno en el grupo de animales alimentado con poliaminas. El efecto bifidogénico de los FOS se asoció con una mayor concentración de poliaminas en el contenido cecal de cerdos neonatales y con una disminución de los parámetros de maduración intestinal analizados. Las cepas seleccionadas por el consumo de FOS, Bifidobacterium spp, Lactobacillus fermentum y Lactobacillus acidophilus fueron capaces de producir poliaminas in vitro. El estudio in vitro, no mostró una relación dosis-dependiente entre la concentración de FOS y la producción de poliaminas bacterianas. / It was evaluated the effects of infant formula supplemented with polyamines and fructooligosaccharides at physiological doses on gut maturation in newborn piglets. Forty newborn piglets were fed maternal milk, a control formula, a formula supplemented with polyamines (5 nmol / ml and 20 nmol spermine / spermidine ml) or a formula supplemented with FOS (8 g/l) (n = 10/experimental group) for 13 days (day 2 after birth through day 15). Animals fed polyamines showed a significant increase in crypt depth of jejunum. The bifidogenic activity of FOS was associated with an increased polyamine concentration in the cecal content of piglets and a decrease in gut maturation parameters analyzed. The Bifidobacterium spp., L. fermentum and L. acidophilus, the most predominant strains after FOS supplementation, were able to produce polyamines in vitro. However, there was not a dose-dependent relationship between FOS addition to the bacterial cecal content and polyamine production in vitro.

HENSIKTEN: Studien beskriver mødre/barn som strevde med amming/diing. Hensikten var å se om tett oppfølging og veiledning økte varighet av amming, og å få kunnskap om mødres opplevelse av ammeproblemer, og ammeveiledning i praksisfeltet. METODE: Studien var en deskriptiv, retrospektiv undersøkelse. Instrumentet var et strukturert spørreskjema med 37 spørsmål. Informantene var alle norsktalende mødre som hadde fått ekstra ammeveiledning og oppfølging ved en helsestasjon i Oslo. Data ble samlet inn via post. RESULTATER: De fleste barna var under en uke gamle ved hjemreise. Der var ingen forskjeller mellom kjønnene. Hyppigst rapporterte dievansker hos barna var sugevansker og dårlig vektøking. I løpet av de første to ukene hadde 75 prosent av ammeproblemene hos mødrene oppstått. Over halvparten av mødrene rapporterte at de hadde behov for ammeveiledning på grunn av sår, sprekker eller infeksjoner på brystknoppene. Langt de fleste mødre mestret ammingen og ammet lenge på tross av store ammeproblemer. Den viktigste motivasjonen mødre oppga for å mestre ammeproblemer var kunnskap om at morsmelk var det beste for barnet. Mødre opplevde at å lykkes med amming hadde en sammenheng med å være en god mor. Støtte fra barnets far var betydningsfull i forhold til beslutningen om å fortsette eller å avslutte ammingen. Mødre beskrev at å få kunnskap, veiledning og oppfølging av helsepersonell med kompetanse, økte selvfølelsen og motiverte dem til å fortsette å amme. KONKLUSJON: Tidspunktet for barnets første måltid viste seg å være en indikator for behov for ammeveiledning både på barselavdelingen og etter hjemkomst. Bruk av morsmelkerstatning tidlig i ammeforløpet var en markør for kortere varighet av amming. Det er av sentral betydning å sikre at mødre får ammeveiledning før hjemreise, og at veiledningen blir gitt etter individuelle behov basert på kunnskap. Mødres behov for ammeveiledning ved hjemkomst med barnet, er en sentral del av det forebyggende arbeidet ved helsestasjonen både i forhold til barnets ernæring og mors mestring / AIM: The study describes mothers and children who strived with the breastfeeding dyad. The aim was to see if information, help and close support increase duration of breastfeeding and to gather information of mothers’ experience of breastfeeding problems and breastfeeding support in practise. METHOD: The study had a descriptive, retrospective design. Data were gathered through a postal questionnaire with 37 questions. The informants were Norwegian speaking mothers who had received extra breastfeeding help and support at a well-baby clinic in Oslo. RESULTS: The majority of children were under a week old when discharged from hospital. There were no differences in gender. The children’s most reported problems were suckling problems, and failure to thrive. 75 % of the breastfeeding problems among mothers occurred during the first two weeks. More than half of the mothers reported the reason for breastfeeding problems to be sore, cracked and/or infected nipples. The majority of the mothers coped with breastfeeding in spite of huge breastfeeding problems, and breastfed for a long period. Knowledge of how mothers milk protects the baby was the most important motivation for coping with breastfeeding problems. To succeed with breastfeeding was related to the feeling of being a good mother. Support from the child’s father was important for the mother’s decision to continue or to stop breastfeeding. The mothers described that to be given knowledge, counselling and support from competent health workers increased their self confidence and motivation to continue breastfeeding. CONCLUSION: The time of breastfeeding initiation was an indicator for mothers who needed breastfeeding support both in maternity ward and in the well-baby clinic. The use of supplements in addition to breastfeeding at an early stage was a marker for shorter duration of breastfeeding. It is important to ensure that mothers get breastfeeding support before discharge from hospital and that the support is individual and based on knowledge. Mothers’ need of breastfeeding support after discharge from hospital is a central part of health promotion at the well-baby clinic as it concerns the baby’s nutrition and the mothers mastering. / <p>ISBN 91-7997-138-5</p>

Submitted by LUIZA TAVARES CARNEIRO SANTIAGO null (luiza_tcs@hotmail.com) on 2016-05-23T14:20:11Z No. of bitstreams: 1 Dissertação Mestrado - Luiza Tavares Carneiro Santiago.pdf: 1233741 bytes, checksum: bb457286bd0f32f04ccc8f34ad966dc1 (MD5) / Approved for entry into archive by Felipe Augusto Arakaki (arakaki@reitoria.unesp.br) on 2016-05-24T12:46:40Z (GMT) No. of bitstreams: 1 santiago_ltc_me_bot.pdf: 1233741 bytes, checksum: bb457286bd0f32f04ccc8f34ad966dc1 (MD5) / Made available in DSpace on 2016-05-24T12:46:40Z (GMT). No. of bitstreams: 1 santiago_ltc_me_bot.pdf: 1233741 bytes, checksum: bb457286bd0f32f04ccc8f34ad966dc1 (MD5) Previous issue date: 2016-02-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / INTRODUÇÃO: O efeito da idade gestacional e do crescimento fetal nos imunocomponentes do leite materno ainda é pouco conhecido. OBJETIVO: Determinar a quantidade de citocinas no colostro em função da idade gestacional e do crescimento fetal. MÉTODO: Estudo transversal, envolvendo mães de recém-nascidos prematuros (PT) e de termo (T), nascidos na Maternidade da Faculdade de Medicina de Botucatu – UNESP, em 2014-2015. Critério de inclusão: gestação única; ausência de diabetes materno, ou uso de medicações/drogas ilícitas, sorologias negativas; recém-nascido com peso adequado (AIG) ou pequeno para idade gestacional (PIG) e sem malformação. Excluídos: não obtenção do colostro, mastite, uso de medicamento pela puérpera. Foram estudados 4 grupos: PT-PIG (n=18), PT-AIG (n=42), T-PIG (n=45), T-AIG (controle, n=42). No colostro coletado entre 24-72 horas pós-nascimento, foram dosadas as citocinas (IL-1β, IL-6, IL-8, IL-10, IL-12 e TNF-α) por citometria de fluxo. Na comparação entre grupos utilizou-se o Qui-quadrado ou teste Exato de Fisher, ANOVA, e Correlação de Pearson. RESULTADOS: As características maternas foram semelhantes nos 4 grupos. A idade gestacional média foi 34 semanas nos prematuros e 39 semanas nos termos. Os níveis de citocinas do colostro não diferiram entre os grupos de termo e pretermo. O grupo T-PIG apresentou maior quantidade de citocinas comparado aos demais. Nos 4 grupos houve correlação entre as citocinas, especialmente nos T-PIG. CONCLUSÃO: A quantidade de citocinas no colostro foi influenciada pelo crescimento fetal e não pela idade gestacional. / INTRODUCTION: The effect of gestational age and foetal growth in the imunno componentes of human milk is not well stablished. OBJECTIVE: To determine cytokines levels in colostrum according to gestational age and foetal growth. METHOD: Cross-sectional study with mothers of term (T) and preterm (PT) infants, with birth weight appropriate-for-gestational age (AGA) and small-for-gestational age (SGA), born at the Maternity of Botucatu School of Medicine- UNESP, during 2014 -2015. Inclusion criteria were: single gestation; absence of diabetes mellitus; no maternal use of medications or illicit drugs; negative maternal serology; and newborn without malformation. Mothers with mastitis, or use of medication, or failure to obtain colostrum, were excluded. Four groups were studied: PT-SGA (n=18), PT-AGA (n=42), T-SGA (n=45), and T-AGA (control, n=42). Colostrum was collected between 24-72 hours after birth, and cytokines (IL-1β, IL-6, IL-8, IL-10, IL-12 and TNF-α) were measured by flow cytometry. Chi-square or Fisher's exact test, ANOVA and Pearson's correlation were used to evaluate differences among the groups. RESULTS: Maternal characteristics did not differ between groups. The mean gestational age was 34 and 39 weeks for preterm and term groups. Cytokines levels in the colostrum were not different between term and preterm groups. However cytokines levels were significantly higher in colostrum from mothers of T-SGA. A positive correlation between cytokines was found in all groups, especially in T-SGA. CONCLUSION: Cytokines levels in colostrum was influenced by foetal growth, while the correlation between cytokines varied according to gestational age and foetal growth. / FAPESP: 2014/12784-9

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2017-04-19T19:30:59Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ronilson_ferreira_freitas.pdf: 5087070 bytes, checksum: a5bcb636f9ce2c039312753f72cda782 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2017-04-20T16:50:48Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ronilson_ferreira_freitas.pdf: 5087070 bytes, checksum: a5bcb636f9ce2c039312753f72cda782 (MD5) / Made available in DSpace on 2017-04-20T16:50:48Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) ronilson_ferreira_freitas.pdf: 5087070 bytes, checksum: a5bcb636f9ce2c039312753f72cda782 (MD5) Previous issue date: 2016 / O objetivo deste estudo foi avaliar e relacionar a qualidade da dieta materna e a composi??o do leite humano em ?cidos graxos no primeiro trimestre de lacta??o. Trata-se de um estudo epidemiol?gico observacional, transversal que foi desenvolvido no per?odo de agosto de 2014 ? dezembro de 2015. A amostra constituiu-se de 106 nutrizes residentes na zona urbana da cidade de Diamantina, Minas Gerais, Brasil. Os instrumentos de coleta dos dados foram question?rio semiestruturado para caracteriza??o da amostra e o recordat?rio de ingest?o habitual. A qualidade da dieta foi avaliada por meio do ?ndice de Alimenta??o Saud?vel validado para a popula??o brasileira (IAS). Amostras de leite materno maduro foram obtidas de 106 nutrizes, a partir da 5? semana p?s-parto, por meio de ordenha manual. A extra??o da gordura do leite foi realizada atrav?s do m?todo de Bligh-Dyer, e metiladas com met?xido de s?dio 0,25 mol/l em metanol dietil ? ?ter. O perfil de ?cidos graxos do leite foi determinado por um Cromat?grafo a G?s equipado com detector por ioniza??o de chamas. Para as an?lises deste estudo, foram estimadas as porcentagens m?dias e desvios padr?o, as medianas e intervalos interquart?licos. Utilizou-se o teste de Kolmogorov-Sminorv para testar a normalidade dos dados. Foi realizado teste de Correla??o de Pearson e de Spearman, para verificar associa??o entre as vari?veis. Posteriormente foi realizada a an?lise de regress?o linear m?ltipla e an?lise de regress?o multivariada. A pontua??o m?dia do IAS total de 64,36?10,68 e os alimentos do grupo das frutas total, fruta inteira, cereal total, cereal integral e leite e derivados, foram os componentes do IAS das nutrizes com menores pontua??es, e com maior frequ?ncia de nota m?nima. Foi poss?vel observar um baixo consumo de frutas totais, frutas inteiras, cereais totais, cereais integrais e leite e derivados. Dentre os ?cidos graxos saturados, foram observados valores mais elevados para os ?cidos graxos palm?tico (C16:0), este?rico (C18:0), mir?stico (C14:0) e l?urico (C12:0), respectivamente. Entre os ?cidos graxos mono-insaturados, verificou-se maior contribui??o dos ?cidos graxos oleico (C18:1) e palmitoleico (C16:1), respectivamente. O total de ?cidos graxos essenciais (linoleico e ?- linol?nico) foi de 14,94%.Foi poss?vel observar uma rela??o inversa entre o consumo de frutas totais com o perfil de ?cidos graxos poli-insaturados, e uma rela??o direta entre o consumo de frutas totais e cereais totais com os ?cidos mono-insaturados e saturados, o que sugere que a qualidade da dieta reflete na composi??o de ?cidos graxos do leite materno. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / The aim of this study was to evaluate and relate the quality of maternal diet and the composition of human milk fatty acids in the first quarter of lactation. This is an observational epidemiological study, cross that was carried out from August 2014 to December 2015. The sample consisted of 106 nursing mothers living in the urban area of the city of Diamantina, Minas Gerais, Brazil. Collection instruments data were semi-structured questionnaire to characterize the sample and usual intake recall. The quality of the diet was assessed by the Healthy Eating Index validated for the Brazilian population (IAS). Mature human milk samples were obtained from lactating 106, from the 5th week after birth, by manual milking. The extraction of milk fat was performed using the Bligh-Dyer method and methylated with sodium methoxide 0.25 moles/l in methanol diethyl - ether. The profile of fatty acids of milk was determined by a gas chromatograph equipped with a flame ionization detector. For the analysis of this study, the estimated mean and standard deviation percentages, medians and interquartile ranges. We used the Kolmogorov-Sminorv test to test the normality of the data. It was performed Pearson correlation test and Spearman to verify associations between variables. Later it was performed the analysis of multiple linear regression and multivariate regression analysis. The average score of all IAS 64.36?10.68 and the food group of all fruits, whole fruit, whole grain, whole grain and dairy products, were the components of the IAS of nursing mothers with lower scores, and more frequency minimum score. It was observed a low intake of total fruits, whole fruits, total grains, whole grains and dairy products. Among the saturated fatty acids, higher values were observed for palmitic fatty acid (C16: 0), stearic (C18: 0), myristic (C14: 0) and lauric (C12: 0), respectively. Among the mono-unsaturated fatty acids there was a higher contribution from the fatty acids oleic (C18: 1) and palmitoleic (C16: 1), respectively. The total essential fatty acids (linoleic and linolenic ?-) was 14.94%. It was observed an inverse relationship between the intake of total fruit with the profile of polyunsaturated fatty acids, and a direct relation between the consumption of total fruit and total cereal with the monounsaturated and saturated acids, which suggests that the quality diet reflects the fatty acid composition of breast milk.

In the first part of the diploma thesis we describe current state of taking care of newborns with special regard to mother's and newborn's needs and to the individual developmental care. We pay attention to the composition of the nursing team and to the conditions for its effective functioning. We cope with the importance of breast milk, breastfeeding and whole-community-based activities supporting breastfeeding. In the chapter about lactation consultancy we look into the history and present day to give a sense of this topic. The aim of the thesis is to make the description of the role of lactation consultant in the multidisciplinary team which takes care of premature newborns. We try to assess contribution of his presence to mothers of newborns and to nurses in the perinatal centres and at the same time to identify the problems lactation consultant are facing. We applied a qualitative research method of semi-structured interview for purpose of the study. We conducted the interviews with mothers of preterm infants, with nurses from the nursing team and with lactation consultants in ÚPMD in Prague and in České Budějovice Hospital. We investigated the rate of integration of lactation consultants into the nursing team within all perinatal centres in the Czech Republic. Lactation consultant provides mothers help with the stimulation of milk production and with the long-lasting breastfeeding maintenance. Lactation consultant supports mothers in breastfeeding and resolves problems related to breastfeeding a premature newborn. This help includes the psychological support. In relation to nurses, lactation consultant takes part in mothers' education in breastfeeding, manages human colostrum and mediates the mother-and-child contact when mother is separated from her baby. Nursing team is enriched with special knowledge and skills of lactation consultant. There were several problems identified: a lack of time for consultancy, the language barrier along with different cultural habits within minorities and the negative influence of layman discussion forums in the internet. Related to collaboration in the nursing team we encountered the problem of poor communication among lactation consultants and other team members. Mothers together with other team members, they all benefit from presence of lactation consultant in the nursing team.

Submitted by Izabel Monteiro (izabel_22@hotmail.com) on 2016-06-17T15:37:27Z No. of bitstreams: 1 Dissertação - Karine Silveira Nascimento.pdf: 964819 bytes, checksum: c3d259ce399a54a62fdc23cec02dd24c (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2016-06-23T19:27:27Z (GMT) No. of bitstreams: 1 Dissertação - Karine Silveira Nascimento.pdf: 964819 bytes, checksum: c3d259ce399a54a62fdc23cec02dd24c (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2016-06-23T19:32:02Z (GMT) No. of bitstreams: 1 Dissertação - Karine Silveira Nascimento.pdf: 964819 bytes, checksum: c3d259ce399a54a62fdc23cec02dd24c (MD5) / Made available in DSpace on 2016-06-23T19:32:02Z (GMT). No. of bitstreams: 1 Dissertação - Karine Silveira Nascimento.pdf: 964819 bytes, checksum: c3d259ce399a54a62fdc23cec02dd24c (MD5) Previous issue date: 2014-09-30 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Human milk, through the peculiarities of its nutritional composition is undoubtedly the most suitable to overcome such shortcomings food, allowing the newborn optimum adaptation to their new environment. Lyophilization is an operation of removing water by sublimation of ice. The use of lyophilization technology dehydration by cold (freeze dry) is a reliable method of preservation of biological products, being free from preservatives or chemicals. The objectives of this study were to evaluate the effects of freeze drying on the nutritional aspects and as an alternative conservation of human milk, as well as evaluating the package which best preserves this freeze dried food. For lyophilization, samples of 600 mL of colostrum and mature milk pasteurized 600mL were collected in the Human Milk Bank Fezinha Anzoategui of Woman Institute Dona Lindu, Manaus/AM. We determined the contents of lipids, proteins, carbohydrates, moisture and ash, besides the determination of vitamin A and proves reconstitution. The research protocol includes three storage conditions: time 0, three months in plastic wrap and foil pouch for three months under refrigeration. Analyses were performed in triplicate and then analyzed statistically. The average of the levels of lipid and protein were lyophilized colostrum of 1.64 g / dl and 1.70 g / dl, respectively. It was observed that protein content of mature milk lyophilized (1.59 g / dL) was still higher than the values previously observed in other studies. The average percentage of carbohydrate in the mature milk lyophilized (7.84 g / dL) is also in agreement with the literature. In comparing the types of packaging, there were no significant differences in moisture, lipid, carbohydrate and ash lyophilized colostrum stored for three months in a metal or plastic container. However, the protein content showed significant difference, suggesting that the metal packaging is a better option in the conservation of lyophilized colostrum for the preservation of this nutrient. In comparing the types of packaging, there were no significant differences in moisture, protein, carbohydrate and ash lyophilized mature milk stored for three months in a metal or plastic container. However, the lipid content significantly different, suggesting that the metal packaging is a better option in the conservation of the lyophilized mature milk in relation to the preservation of this nutrient. The concentration of vitamin A found in the colostrum before and after lyophilization were 1.21μmol/L and 1.16μmol/L, respectively. Regarding mature milk, the levels of 1.18μmol/L before lyophilization and 1.14μmol/L were found after processing. The loss of vitamin A during processing is probably the result of exposure to light bottles during thawing and re-bottling. The procedure used for reconstitution could be seen that the color was similar to non-lyophilized milk, fluidity remained stable, similar to the non-lyophilized milk and dilution was full, without formation of precipitates. The freeze-drying technique was favorable for preservation of human milk as it preserved the nutrients in human milk. It is suggested that the canister is the best alternative for the conservation of lyophilized human milk. / O leite humano, através das peculiaridades de sua composição nutricional, é sem dúvida o alimento mais adequado para superar deficiências, permitindo ao recém-nascido uma ótima adaptação ao seu novo ambiente. A liofilização é uma operação de remoção da água por sublimação do gelo. O uso da tecnologia da liofilização ou a desidratação a frio (freeze dry) é um processo confiável de conservação de produtos biológicos, sendo isento de conservantes ou produtos químicos. O objetivo do estudo foi avaliar os efeitos do processo de liofilização nos aspectos nutricionais e como alternativa de conservação do leite humano, bem como avaliar a embalagem que melhor conserva este alimento liofilizado. Para a liofilização, foram coletadas amostras de 600mL de colostro e 600mL de leite maduro pasteurizados no Banco de Leite Humano Fezinha Anzoategui do Instituto da Mulher Dona Lindu, Manaus/AM. Foram determinados os conteúdos de lipídios, proteínas, carboidratos, umidade e cinzas, além da determinação da vitamina A e prova de reconstituição. O protocolo de pesquisa inclui três condições de estocagem: tempo zero e três meses, assim como armazenamento em embalagem plástica e metálica sob refrigeração. As análises foram realizadas em triplicata em seguida analisadas estatisticamente. As médias dos teores de lipídio e proteína do colostro liofilizado foram de 1,64 g/dL e 1,70 g/dL, respectivamente. Observou-se que teor de proteína do leite maduro liofilizado (1,59 g/dL) encontrava-se superior aos valores já observados em outros estudos. A média dos teores de carboidrato do leite maduro liofilizado (7,84 g/dL) está também em concordância com a literatura. Na comparação entre os tipos de embalagem, não houve diferenças significativas dos teores de umidade, lipídio, carboidrato e cinzas do colostro liofilizado armazenado por três meses em embalagem metálica ou plástica. Porém, o teor de proteína apresentou diferença significativa, sugerindo que a embalagem metálica é uma melhor opção na conservação do colostro liofilizado em relação à preservação desse nutriente. Na comparação entre os tipos de embalagem, não houve diferenças significativas dos teores de umidade, proteína, carboidrato e cinzas do leite maduro liofilizado armazenado por três meses em embalagem metálica ou plástica. Porém, o teor de lipídio apresentou diferença significativa, sugerindo que a embalagem metálica é uma melhor opção na conservação do leite maduro liofilizado em relação à preservação desse nutriente. As concentrações de vitamina A encontradas nos colostros antes e após a liofilização foram 1,21μmol/L e 1,16μmol/L, respectivamente. Em relação ao leite maduro, foram encontrados os teores de 1,18μmol/L antes da liofilização e 1,14μmol/L após o processamento. A perda de vitamina A durante o processamento provavelmente é resultante da exposição dos frascos à luz durante o descongelamento e reenvase. No procedimento utilizado para reconstituição pôde-se verificar que a cor foi semelhante ao leite não-liofilizado, a fluidez continuou estável, semelhante ao leite não-liofilizado e a diluição foi plena, sem formação de precipitados. A técnica de liofilização mostrou-se favorável para conservação do leite humano já que preservou os nutrientes presentes no leite humano. Sugere-se que a embalagem metálica seja a melhor alternativa para a conservação do leite humano liofilizado.

Very low birth weight and extremely low birth weight neonates have tremendous risk of mortality. This is a grave concern; however, survival alone is not the goal of neonatal intensive care. Survival, along with a reduction or elimination of life long morbidity is the aim of neonatal intensive care. Human milk is known as the best nutrition for babies and a growing body of evidence supports that human milk is critical in helping these fragile neonates mitigate the overwhelming risks they face. Therefore, the purpose of this study was to examine the relationship between neonatal severity of illness and human milk, specifically mothers own milk (MOM), donor human milk (DHM), and total human milk (THM) intake in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants over the first six weeks of life. Although there is a growing body of evidence that supports the use of human milk in this fragile neonatal population, information is lacking about the relationship between human milk and neonatal illness severity. The current study was a secondary data analysis from a National Institutes of Health (NIH) funded R21 study in a level three NICU in Florida. Multilevel modeling was used for data analysis to examine relationships between maternal dyad characteristics and severity of illness, operationalized by the Score for Neonatal Acute Physiology-II (SNAP-II), at 12 hours of life and at the end of each week of life for six weeks. Growth models (linear, quadratic, piecewise) were examined to determine the best model fit for the data, then predictor variables were added and model fit was tested. Birth weight was added to final models as a control as it is seen as a proxy for severity of illness in the literature. Model six demonstrated a significant inverse relationship between MOM(mL) (γMOM(mL)) = -.000079, p < .05) and SNAP-II scores (Deviance = 287.862, Δχ2(df) = 31.38(1), p < .001, AIC = 303.862, BIC = 336.930). Model 11 demonstrated a significant inverse relationship between THM(mL) (γTHM(mL) = -.000127, p < .001) and SNAP-II scores (Deviance = 279.280, Δχ2(df) = 30.859(1), p < .001, AIC = 295.280, BIC = 328.347). No relationships were noted between severity of illness and DHM(mL), MOM(%), DHM(%), or THM(%). Therefore the relationships noted between MOM(mL) and THM(mL) and neonatal severity of illness should be interpreted with caution.

The purpose of this study was to compare growth following hospitalization in preterm, low birth weight infants fed their own mother's milk versus preterm, low birth weight infants of similar weight and gestational age given standard infant formula upon demand. Growth measurements were taken 40, 42, 48 and 56 weeks postconceptual age. A total of 28 healthy, preterm, low birth weight infants completed the study. Seventeen infants received standard infant formula (Similac) and 11 were breast-fed upon demand. Introduction of solid foods was delayed until the infant was greater than 56 weeks postconceptual age. Weight, length, occiptial frontal circumference, mid-upper arm circumference, triceps and subscapular skinfold measurements were obtained at 40, 42, 48 and 56 weeks postconceptual age in our nutrition follow-up clinic. Analysis of variance with feeding as well as age, sex, gestational age at birth, birth weight, birth length and birth head circumference as factors was performed utilizing Duncan's Multiple Range Test. Weight, mid-upper arm circumference, and triceps and subscapular skinfold measurements were shown to be significantly greater in infants fed formula versus human milk from birth to 40 weeks postconceptual age. Gestational age at birth and increasing chronological age was also shown to influence these measures. Statistical significance was less than the one percent level. However, no statistical or clinical differences were found in rates of growth preterm, low birth weight infants fed either human milk or standard infant formula from 40 to 56 weeks postconceptual age. Both feeding groups experienced growth within the 10 to 90th percentiles of accepted infant norms for all parameters. It was concluded that preterm, low birth weight infants allowed to be breast-fed upon demand post-hospitalization experienced acceptable rates of gains from 40 to 56 weeks postconceptual age. Use of commercial formula was not found to be more advantageous than breast feeding.

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Background Modern neonatal care has improved the survival rate of extremely preterm infants. These infants are at high risk of malnutrition and growth failure during 3-4 months of hospital care. The objectives of this study was to investigate nutritional intakes during hospitalization and explore associations between nutritional intakes, postnatal growth and retinopathy of prematurity (ROP). Perioperative nutrition in infants undergoing surgery for patent ductus arteriosus (PDA) was also investigated. Methods This is a population-based study of Swedish extremely preterm infants (&lt;27 weeks) born during 2004-2007 (n=602). Detailed data on nutritional supply and anthropometric measurements during hospitalization were retrospectively retrieved from hospital records. Comprehensive data on cohort characteristics, neonatal morbidity and infant mortality were obtained from the Extremely Preterm Infants in Sweden Study (EXPRESS). Results During the first 70 days of life, intakes of energy, protein and several micronutrients, with the exception of iron and some vitamins, were less than estimated requirements, and infants showed severe postnatal growth failure. Energy and protein intake predicted growth in all anthropometric outcomes even when adjusting for severity of illness, and fat intake was positively associated with head growth. Low folate intake was positively correlated with poor weight and length gain while high iron intake, mainly explained by blood transfusions, was negatively associated with poor length gain. Furthermore, a low energy intake was associated with severe ROP (stage 3-5). An increased energy intake of 10 kcal/kg/d was associated with 24% decrease in severe ROP (p=0.01). During the first month, 99% of the infants were exclusively fed human milk. Infants who underwent surgery for PDA (n=140) were malnourished, with energy and macronutrient intakes below minimum estimated requirements before, during and after surgery. Conclusions The severe postnatal growth failure observed in Swedish extremely preterm infants may be prevented by improved intakes of energy, protein, fat and folate and a reduction of the number of blood transfusions. Human milk is the main enteral food source and analyses of human milk macronutrient contents facilitates individualized fortification. Provision of adequate energy intakes during the first four weeks of life may be an effective way to reduce the risk of severe ROP. Perioperative nutrition in infants undergoing PDA surgery needs to be improved. The study results have important implications for nutritional regimens, postnatal growth and health outcome in this new generation of survivors.