• 제목/요약/키워드: first breast milk

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Composition of Human Breast Milk Microbiota and Its Role in Children's Health

  • Notarbartolo, Veronica;Giuffre, Mario;Montante, Claudio;Corsello, Giovanni;Carta, Maurizio
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권3호
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    • pp.194-210
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    • 2022
  • Human milk contains a number of nutritional and bioactive molecules including microorganisms that constitute the so-called "Human Milk Microbiota (HMM)". Recent studies have shown that not only bacterial but also viral, fungal, and archaeal components are present in the HMM. Previous research has established, a "core" microbiome, consisting of Firmicutes (i.e., Streptococcus, Staphylococcus), Proteobacteria (i.e., Serratia, Pseudomonas, Ralstonia, Sphingomonas, Bradyrhizobium), and Actinobacteria (i.e., Propionibacterium, Corynebacterium). This review aims to summarize the main characteristics of HMM and the role it plays in shaping a child's health. We reviewed the most recent literature on the topic (2019-2021), using the PubMed database. The main sources of HMM origin were identified as the retrograde flow and the entero-mammary pathway. Several factors can influence its composition, such as maternal body mass index and diet, use of antibiotics, time and type of delivery, and mode of breastfeeding. The COVID-19 pandemic, by altering the mother-infant dyad and modifying many of our previous habits, has emerged as a new risk factor for the modification of HMM. HMM is an important contributor to gastrointestinal colonization in children and therefore, it is fundamental to avoid any form of perturbation in the HMM that can alter the microbial equilibrium, especially in the first 100 days of life. Microbial dysbiosis can be a trigger point for the development of necrotizing enterocolitis, especially in preterm infants, and for onset of chronic diseases, such as asthma and obesity, later in life.

한국인 모유 및 어패류 중 PBDEs 잔류 레벨 모니터링 (Monitoring of residue PBDEs level in human milk and fish & shellfish samples collected from Korea)

  • 장명수;차수진;강윤석;박종세
    • 분석과학
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    • 제19권3호
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    • pp.244-254
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    • 2006
  • 난연제는 불길이 확산하거나 초기에 발생하는 것을 억제하는 물질을 의미한다. 난연제로 사용하는 이중 브롬계 난연제인 PBDEs는 갑상선 호르몬 붕괴와 내분비계 교란을 유발하는 물질이다. 본 연구에서는 PBDEs의 분석을 위한 적절한 전처리 방법을 제안하였고, 어류와 패류 포함 총 8종과 서울과 제주 모유 각 20개를 대상으로 BDE-28, 47, 99, 100, 153, 154 및 183의 인체 내 축적 수준을 조사하였다. PBDEs 분석을 위한 전처리 방법으로는 어패류의 경우 알칼리 분해 추출법을 적용하는 것이 적합한 것으로 확인되었다. 다층 실리카겔 컬럼 정제는 50 mL의 헥산을 이용하여 방해물질을 제거한후, 100 mL의 헥산:디클로로메탄(9:1)로 용출시키는 것이 적합한 것으로 확인되었다. 활성탄 정제 과정은 100 mL의 헥산:디클로로메탄(3:1)으로 용출시키는 것이 적합한 것으로 확인되었다. 어패류를 대상으로 한 실험에서 광어는 습식 중량 기준 890 pg/g이 검출되어, 시료 중 가장 높은 PBDEs 축적 정도를 보였다. 생태는 40 pg/g이 검출되어 시료 중 PBDEs의 축적 정도가 가장 낮은 것으로 나타났다. 모유 시료에서는 서울과 제주 지역에서 지방 중량 기준 2,580 및 3,600 pg/g이 검출되었으며, BDE-153과 183은 모두 검출되지 않았다. 재산과 초산의 경우 3,200 및 3,000 pg/g으로 큰 차이가 없는 것으로 나타났다. 본 연구에서 진행한 어패류 및 인체시료에서의 PBDEs 축적 정도를 파악한 결과, 외국에서 보고한 농도에 비해 낮은 수준을 유지하고 있음을 확인할 수 있었다.

신생아 집중치료실에서 침습 칸디다 감염의 예방 (Prevention of Invasive Candida Infections in the Neonatal Intensive Care Unit)

  • 김천수
    • Pediatric Infection and Vaccine
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    • 제18권1호
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    • pp.15-22
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    • 2011
  • Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

Comparison of the gut microbiota profile in breast-fed and formula-fed Korean infants using pyrosequencing

  • Lee, Sang A;Lim, Ji Ye;Kim, Bong-Soo;Cho, Su Jin;Kim, Nak Yon;Kim, Ok Bin;Kim, Yuri
    • Nutrition Research and Practice
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    • 제9권3호
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    • pp.242-248
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    • 2015
  • BACKGROUND/OBJECTIVES: Feeding in infancy is the most significant determinant of the intestinal microbiota in early life. The aim of this study was to determine the gut microbiota of Korean infants and compare the microbiota obtained between breast-fed and formula-fed Korean infants. SUBJECTS/METHODS: We analyzed the microbial communities in fecal samples collected from twenty 4-week old Korean (ten samples in each breast-fed or formula-fed) infants using pyrosequencing. RESULTS: The fecal microbiota of the 4-week-old Korean infants consisted of the three phyla Actinobacteria, Firmicutes, and Proteobacteria. In addition, five species, including Bifidocbacterium longum, Streptococcus salivarius, Strepotococcus lactarius, Streptococcus pseudopneumoniae, and Lactobacillus gasseri were common commensal intestinal microbiota in all infants. The predominant intestinal microbiota in the breast-fed infants (BFI) included the phylum Actinobacteria (average 70.55%), family Bifidobacteriacea (70.12%), genus Bifidobacterium (70.03%) and species Bifidobacterium longum (69.96%). In the microbiota from the formula-fed infants (FFI), the proportion of the phylum Actinobacteria (40.68%) was less, whereas the proportions of Firmicutes (45.38%) and Proteobacteria (13.85%) as well as the diversity of each taxonomic level were greater, compared to those of the BFI. The probiotic species found in the 4-week-old Korean infants were Bifidobacterium longum, Streptococcus salivarius, and Lactobacillus gasseri. These probiotic species accounted for 93.81% of the microbiota from the BFI, while only 63.80% of the microbiota from the FFI. In particular, B. longum was more abundant in BFI (69.96%) than in FFI (34.17%). CONCLUSIONS: Breast milk supports the growth of B. longum and inhibits others. To the best of our knowledge, this study was the first attempt to analyze the gut microbiota of healthy Korean infants according to the feeding type using pyrosequencing. Our data can be used as a basis for further studies to investigate the development of intestinal microbiota with aging and disease status.

Monitoring of $Clostridium$ $difficile$ Colonization in Preterm Infants in Neonatal Intensive Care Units

  • Chang, Ju-Young;Shim, Jung-Ok;Ko, Jae-Sung;Seo, Jeong-Kee;Lee, Jin-A;Kim, Han-Suk;Choi, Jung-Hwan;Shin, Sue;Shin, Son-Moon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제15권1호
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    • pp.29-37
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    • 2012
  • Purpose: To examine the prevalence of $Clostridium$ $difficile$ ($C.$ $difficile$) colonization (CDC) and potential neonatal determinants of CDC in hospitalized preterm infants. Methods: Fecal samples were serially collected within 72 h after birth and at 1, 2, and 4-6 weeks of age from preterm infants in the neonatal intensive care units (NICUs) of two different university hospitals. Total bacterial DNA was extracted from each fecal sample from 49 infants, and polymerase chain reaction (PCR) was performed with primers for the 16S gene of $C.$ $difficile$ and the toxin A and toxin B genes. The correlation between the results of $C.$ $difficile$ PCR assays and the clinical characteristics of the infants was analyzed. Results: The prevalence rates of CDC were 34.7, 37.2, 41.3, and 53.1% within 72 h after birth and at 1, 2, and 4.6 weeks of age, respectively. The toxin positivity rate was significantly higher in the infants with persistent CDC than in those with transient CDC (8/12 [66.7%] vs. 6/25 [24.5%] ($p$=0.001). Among the various neonatal factors, only the feeding method during the first week after birth was significantly associated with persistent CDC. Exclusive breast-milk feeding (EBMF) significantly decreased the risk of persistent CDC compared to formula or mixed feeding (adjusted odds ratio: 0.133, 95% confidence interval: 0.02-0.898, $p$=0.038). Conclusion: The prevalence of CDC increased with the duration of hospitalization in preterm infants in the NICU. EBMF during the first week after birth in hospitalized preterm infants may protect against persistent CDC.

여성의 개인적 특성과 생활양식요인을 이용한 골량감소 예측모형 (Prediction Model for Reduced Bone mass in Women using Individual Characteristics & Life Style Factors)

  • 이은남;이은옥
    • 근관절건강학회지
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    • 제5권1호
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    • pp.83-109
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    • 1998
  • This study was carried out to identify the Important modifiable risk factors for reduced bone mass and to construct prediction model which can classify women with either low or high bone mass. Through the literature review, individual characteristics such as age, body weight, height, education level, family history, age of menarche, postmenopausal period, gravity, parity, menopausal status, and breast feeding period were identified and factors of life style such as past milk consumption, past physical activity, present daily activity, present calcium intake, alcohol intake, cigarette smoking, coffee consumption were identified as influencing factors of reduced bone mass in women. Four hundred and eighty women aged between 28 and 76 who had given measurement bone mineral density by dual energy x-ray absortiometry in lumbar vertebrae and femur from July to October, 1997 at 4 general hospitals in Seoul and Pusan were selected for this study. Women were excluded if they had a history of any chronic illness such as rheumatoid arthritis, diabetes mellitus, hyperthroidism, & gastrointestinal disorder and any medication such as calcium supplements, calcitonin, estrogen, thyroxine, antacids, & corticosteroids known affect bone. As a result of these exclusion criteria, four hundred and seventeen women were used for analysis. Multiple logistic regression model was developed for estimating the likelihood of the presence or absence of reduced bone mass. A SAS procedure was used to estimate risk factor coefficient. The results are as follows For lumbar spine, the variables significant were age, body weight, menopause status, daily activity, past milk consumption, and past physical activity(p<0.01), while for femoral Ward's triangle, age, body weight, level of education, past milk consumption, past physical activity(p<0.001). Past physical activity, present daily activity and past milk consumption are the most powerful modifiable predictors in vertebrae and femur among the predictors. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 74.1% of persons with reduced bone mass and 84.5% of persons with normal bone mass in the lumbar vertebrae and 82.9% of persons with reduced bone mass and 75.0% of persons with normal bone mass in the femoral Ward's triangle. On the basis of these results, a number of recommendations for the management of reduced bone mass may be made : First, those woman who are classified as high risk group of the reduced bone mass in the prediction model should examine the bone mineral density to further examine the usefulness of this model. Second, the optimal amount of milk consumption and a regular weight bearing exercise in childhood, adolescence, and early adult should be ensured.

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초산부부의 모유수유에 대한 지식, 태도 및 실천의지 (Primiparous Couples' Knowledge, Attitude and Practice regarding Breastfeeding)

  • 강남미
    • 여성건강간호학회지
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    • 제5권3호
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    • pp.379-388
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    • 1999
  • Breastfeeding is an excellent way of feeding infants and continues to be an important source of nutrition and antibodies for infants. Although breast-feeding is believed to be important, the rate of breastfeeding among Korean women is very low. One reason for the low breastfeeding rate is that the health professionals in the past have given little practical help couples to overcome difficulties encountered during breastfeeding. The promotion of breastfeeding has recently become a high priority among health professionals because of the undisputed physiological, psychological, social, economic, and nutritional benefits. Fathers have been found to influence the course of breastfeeding, but no one has conducted a systematic investigation into in and included fathers perspectives of breastfeeding in Korea. It is important to find strategies to solve the problems by assessing the knowledge, attitude and practice of breastfeeding with fathers as well as mothers. The purpose of this research is to find ways to promote primiparous(first child) couples's breastfeeding by assessing their general knowledge, attitude and practice of it. More specifically its purposes is to identify the relationship between knowledge, attitude, practice and the background factors of breastfeeding of primiparous couples in order to promote and support breastfeeding. The data will help health professionals to guide first-pregnancy couples to prepare and overcome any difficulties encountered during breastfeeding. Data were collected through a questionnaire which included both structured and open-ended questions. The questionnaire was composed referencing earlier literature, studies and surveys. This survey was made postpartum 2-3days after childbirth on 96 couples. The numbers of subjects for data analysis were selected 51 couples through pilot screening test. Data were coded and analyzed using the Statistical Package for Social Sciences : Cronbach's alpha coefficient, T-test, ANOVA, Stepwise pearson's correlation coefficient. The relations between the variables of breastfeeding were examined using a Pearson's correlation coefficient. This study showed that, the internal validity of the instrument was tested by Cronbach's alpha. The result was : mother knowledge 0.72, mother attitude 0.88, and father knowledge 0.70, father attitude 0.92, practice 0.76 and planning of breast feeding 0.95. The average age of mothers in the sample was 28.9 years old, and the average age of fathers in the sample was 31.3 years old. The other descriptive informations available included. the study also found that fathers were more important than doctors or nurses. However results of the study indicate that there were no differences between father and mother knowledge of breastfeeding(t=-0.39, p=0.698), and father attitude was statistically significant higher than mother attitude of breastfeeding (t=2.24, p=0.030). In analysis, the variable 'practice' with breastfeeding was the relationship with mother knowledge (p=0.031) and mother attitude(p=0.015). In this study, the correlation between one couple' knowledge and attitude was not significant. Primiparous couples surveyed in the postpartum period regarding knowledge, attitude and practice about breastfeeding might be affected by recall bias, the effects of the euphoria of the first 24-48 hours postpartum, but these variables were not examined. This study results add to the body of knowledge about nursing care for breastfeeding mothers and fathers. This indicates that a need for education about breastfeeding and, that fathers be included in it as well as mothers.

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Longitudinal Study of Iron Concentration in Korean Preterm Human Milk

  • Lim, Gi-Na;Koo, Mi-Sung;Kim, Ellen Ai-Rhan;Min, Won-Ki;Yoon, Sung-Chul
    • Neonatal Medicine
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    • 제18권1호
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    • pp.104-110
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    • 2011
  • 목적: 미숙아에게 필요한 영양성분을 알기 위해서는 그들의 모유 성분을 분석하는 것이 도움이 된다. 저자들은 미숙아 모유의 장기적인 철분함량의 변화를 관찰하고 만삭아 모유와 비교하였으며, 이를 토대로 모유수유만 하는 미숙아에서 철분 보충의 필요성과 지침에 대해 알아보고자 하였다. 방법: 재태연령 34주 미만이거나 출생체중 1,800 g 미만의 미숙아를 출산한 산모 103명으로부터 생후 1, 2, 4, 6, 8, 12주의 모유를 수집하였고, 만삭아의 모유는 24명의 산모로부터 생후 1주째에 수집하여 철분함량을 분석하였다. 결과: 생후 2주에서 8주 사이의 미숙아 모유내의 철분함량은 유의한 차이가 없었으며(36.3${\pm}$23.1~45.8${\pm}$26.0 $\mu$g/dL), 이는 생후 1주째의 미숙아모유 (23.1${\pm}$14.6 $\mu$g/dL)나 만삭아 모유(25.2${\pm}$7.55 $\mu$g/dL)의 철분함량보다는 유의하게 높았다. 교정나이로 만삭이 된 미숙아의 모유(42.2${\pm}$19.4 $\mu$g/dL)는 만삭아의 모유보다 유의하게 높은 철분함량을 나타내었다. 결론: 미숙아 모유의 철분함량은 생후 3개월까지 큰 차이가 없었으며, 이는 필요량보다 적어 모유수유만 할 경우 AAPCON(2004)에서 권유하는 대로 2 mg/kg/day의 철분을 보충하는 것이 좋겠다.

포유류의 종에 따른 초유 단백질의 변화에 대한 분석 (Analysis of Changes in Colostrum Proteins by Mammalian Species)

  • 김승희;김완섭
    • Journal of Dairy Science and Biotechnology
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    • 제35권2호
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    • pp.105-111
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    • 2017
  • 젖소, 한우, 돼지, 그리고 산양의 초유 중 단백질의 변화를 초일부터 7일까지 조사하였다. 돼지의 초유를 제외한 젖소, 한우, 그리고 산양의 초유에서 면역글로불린, 락토페린, 락토퍼옥시데이스, 혈청 알부민, IgG heavy chain, 그리고 IgG light chain은 분만 후, 초일 함량이 현저히 높았고, 2일째부터 급격히 감소하는 것을 보여 주었다. 그리고 ${\alpha}_{S2}$-카세인, ${\alpha}_{S1}$-카세인, ${\beta}$-카세인, ${\kappa}$-카세인, ${\beta}$-락토글로불린 및 ${\alpha}$-락트알부민은 분만 직후부터 7일까지 현저한 함량의 차이는 나타나지 않았다. 한편, 돼지 초유의 경우는 모든 단백질이 분만 후, 초일부터 2일까지 높은 함량을 나타내었다.

선천성 수신증 환자군과 첫 발열성 요로감염으로 진단 시 발견된 수신증 환자군에서 임상적 특징에 따른 발열성 요로감염의 발생률 (Incidence of Febrile Urinary Tract Infection According to Clinical Characteristics in Patients with Congenital Hydronephrosis and Hydronephrotic Patients Diagnosed at First Febrile Urinary Tract Infection)

  • 김근정;이선경;이준호
    • Childhood Kidney Diseases
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    • 제14권2호
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    • pp.184-194
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    • 2010
  • 목 적 : 선천성 및 첫 발열성 요로감염으로 진단시 발견된 수신증 환자들에서 임상적 특성에 따른 발열성 요로감염의 발생률을 확인하고자 하였다. 방 법 : 본 연구는 2000년부터 2009년까지 10년간 선천성 수신증으로 진단 받은 200명(군 1)과 첫 발열성 요로감염으로 진단 시 발견된 신장 초음파상 수신증으로 진단받은 252명(군 2)을 대상으로 하였다. 두 군에서 각각 임상적 특징, VUR의 유무, 수유방법, 그리고 선천성 수신증의 임상 경과에 따른 요로감염의 발생 빈도에 대해 알아보았다. 그리고, 그 결과들을 분석하였고, 두 군을 서로 비교하였다. 결 과 : 군 1과 군 2에서 요로감염의 발생률 및 재발률은 각각 10%, 16.7%이며, 요로감염의 연간 발생 빈도(episodes per person-years) 및 재발 빈도는 각각 0.028, 0.051였다. 군 2에서 군 1에 비해 VUR이 많았고(3% vs. 27%, P<0.05), 요로감염의 발생률이 높았다. 군 2에서만 VUR등급이 높을수록 요로감염의 발생률이 높았다(P=0.032). 군 1에서 SFU grade 4와 VUR grade 4-5에서 요로감염의 발생률은 각각 80%, 44.4%였다. 두 군 모두에서 모유 수유 환아들과 분유 수유 환아들 사이에 요로감염의 발생률은 차이가 없었다(P 1=0.274, P 2=0.4). 선천성 수신증의 호전 시기(<1 vs. 1-2 vs. >2 year-old vs. no resolution over 2 year-old)에 따른 요로감염의 발생률과 VUR의 유무는 유의한 차이가 없었다. 결 론 : 선천성 수신증 및 첫 발열성 요로감염으로 진단 시 발견된 수신증 환아에서 SFU grade 4 또는 VUR 4-5를 제외하고는 전반적인 요로감염의 발생률은 낮았다. 모유 수유는 급성 요로감염의 발생 예방에 효과가 없다.