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AUGUST 2011

Greetings from the Prolacta Team

LATCH… "to acquire understanding of, to comprehend"

Prolacta Bioscience's eNewsletter serves to extend our mission of "making a meaningful difference in the lives of thousands of the most vulnerable infants through world class research and innovative products" by providing the health care professional with a brief overview of evolving research, current clinical issues and emerging strategies relevant to the care of the premature infant and sick newborn.

Guidelines for Preparation of Human Milk and Formula in Health Care Facilities

Guidelines for Preparation of Human Milk and Formula in Health Care FacilitiesThe revised second edition of Infant Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities (S.T. Robbins & R. Meyers, Eds.) was published in April 2011. This current volume, seven years after the original text, continues its strong emphasis on assuring patient safety.

The updated volume provides remarkably detailed guidelines that any hospital or facility providing care to infants should follow to ensure safe preparation, handling and administration of human milk. The authors note that while guidelines are essential to ensure infection control and avoid errors, such guidelines should not be considered regulations, as they are based on the limited research currently available. The need for additional scientific evidence and evolving clinical research in the area of human milk handling remains crucial.

The intended outcome for the guidelines are to (1) help ensure that infants within a health care facility receive optimal nutritional care; (2) ensure that health care personnel have state-of-the-art guidelines for the preparation of human milk and (3) assure the public that infants in health care facilities receive proper nourishment prepared in a safe manner. The textbook is available for purchase through the American Dietetic Association at http://www.pnpg.org/node/10817.

The Effect of an Exclusive Human Milk Diet on the Pharmacoeconomics of NEC

Journal Breastfeeding MedicineA new study published online ahead of print by the Journal Breastfeeding Medicine looks at the health economic implications of feeding extremely premature (EP) infants a 100% human milk-based diet. The study, from the pharmacoeconomics center at the University of Southern California used California Medicaid (Medi-Cal) data to derive the cost of treating extremely premature Infants, along with the extra costs incurred if the infant develops Necrotizing Enterocolitis (NEC). They also determined the extra costs incurred if surgical intervention is required to treat NEC.

The USC group found that if the difference in NEC rates and need for surgery seen with the human diet were applied to all of the infants born in California at 28 weeks gestation or less, a savings of $8,167 per EP baby would result . Nationally, the total economic benefit from avoided direct and mortality costs would be a $1.8-2.1 billion per year savings. The group also found that EP infants who do not develop NEC have a NICU length of stay that is almost 4 days shorter than babies who do get NEC thus freeing up valuable medical resources sooner. Once these costs were established the authors applied the results reported last year in a paper looking at the impact of using a completely human-milk based diet in premature Infants weighing less than 1250g at birth.1 That paper reported a 65% decreased in the incidence of NEC and an 8 fold reduction in the odds of needing surgery in the group getting the fully human milk based diet compared with the group getting the standard diet which includes bovine-based components.

The article may be found here (no subscription is necessary)

Click Here to View Publication

Breastfeeding and a Reduced Risk of Sudden Infant Death Syndrome

Breastfeeding and a Reduced Risk of Sudden Infant Death SyndromeBreastfeeding has been associated with a lower risk of post-neonatal morbidity and mortality. A meta-analysis examining the influence of breastfeeding on the reduction of risk for Sudden Infant Death Syndrome (SIDS) was published online in the Journal Pediatrics in June 2011.

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Physiologic studies have demonstrated that breast fed infants have lower arousal thresholds than formula fed infants and this has been hypothesized to be protective for SIDS. Epidemiologic studies however have been inconsistent in demonstrating this protective effect. This multi- site study identified 288 studies with data on breastfeeding and SIDS. Teams of reviewers further evaluated the quality of these studies based on criteria developed by the American Academy of Pediatrics Task Force on Positioning and SIDS, resulting in 18 studies for analysis.

The meta-analysis revealed that breastfeeding to any extent and of any duration is protective against SIDS. There was a significantly decreased risk of SIDS for infants who received any amount of breast milk for any duration (univariable SOR, 0.40; multivariable SOR, 0.55). There was also a significant decrease in the risk of SIDS for any breastfeeding at age 2 months or older, (univariable SOR, 0.38). The risk of SIDS was significantly decreased for exclusive breastfeeding of any duration (univariable SOR, 0.27).

Although causation cannot be proven in case-controlled studies and there were a small number of studies in this analysis that presented data on the duration of breastfeeding, the authors concluded that breastfeeding is protective against SIDS and this effect is stronger when breastfeeding is exclusive. The recommendation to breastfeed infants should be included with other SIDS risk-reduction strategies to both reduce the risk of SIDS and promote breastfeeding for its many other infant and maternal health benefits.

World Breastfeeding Week August 1-7, 2011

World Breastfeeding Week August 1-7, 2011World Breastfeeding Week is celebrated every year from August 1-7 in more than 120 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) policy-makers in August 1990 to protect, promote and support breastfeeding. The World Alliance for Breastfeeding Action (WABA) describes breastfeeding support as occurring in two dimensions: time (prepregnancy to weaning) and place (the home, community, health care system) but note that neither has much impact without a third dimension – communication. Visit their website at http://worldbreastfeedingweek.org to review news, events and activities associated with World Breastfeeding Week and to learn more regarding their intergenerational media theme of "Talk to Me! Breastfeeding – a 3D Experience".



To learn more about Prolacta's human milk products, please go to www.prolacta.com.