Advertise on podcast: Speaking of Human Milk

Explore the latest research comparing bovine and human milk-based fortifiers for preterm infants. Learn from Dr. Boris W. Kramer, Clinical Professor and Neonatologist, as he examines the importance of evidence-based medicine and consider future directions in neonatal nutrition. Objectives: Review the importance of evidence-based medicine for fortification in preterm infants.Explore the latest evidence comparing bovine versus human milk-based fortifiers.Examine if we need additional evidence on this topic.Disclaimer: The experiences, opinions, and results shared in this video reflect those of the speaker and do not necessarily represent the views of Prolacta. Certain statements, including referenced studies, are based on data that have been submitted to or evaluated by the U.S. Food and Drug Administration (FDA); however, other statements reflect the speaker’s interpretations and have not been reviewed by the FDA. Professor Kramer received compensation from Prolacta for this presentation and provides additional services to the company.

NICU dietitian Patti Perks and CICU dietitian Megan Horsley: Discuss published criteria for defining malnutrition in pediatric and neonatal populationsIdentify variables that impact nutrition and growthDiscuss the application and challenges of malnutrition criteriaIdentify potential outcomes of diagnosing malnutrition

In this episode: Neonatalogist Dr Evelyn D Rider talks about the benefits of early fortification with human milk–based fortifiers in babies born weighing 1250 grams and how Prolacta’s fortifiers reduced the overall cost of care in her neonatal intensive care unit (NICU). Show notes: Huston R, Lee M, Rider E, et al. Early fortification of enteral feedings for infants 1250 grams birth weight receiving a human milk diet including human milk based fortifier. J Neonatal Perinatal Med. 2020;13(2):215-221. doi:10.3233/NPM-190300

In this episode: Neonatal nurse Amy Paradis discusses the strategies used in her NICU to prevent late-onset sepsis and the evidence regarding the use of an Exclusive Human Milk Diet on reducing the incidence of and evaluations for late-onset sepsis. Show notes: Hair AB, Peluso AM, Hawthorne KM, et al. Beyond necrotizing enterocolitis prevention: improving outcomes with an exclusive human milk-based diet [published correction appears in Breastfeed Med. 2017;12 (10 ):663]. Breastfeed Med. 2016;11(2):70-74. doi:10.1089/bfm.2015.0134 Delaney Manthe E, Perks PH, Swanson JR. Team-based implementation of an exclusive human milk diet. Adv Neonatal Care. 2019;19(6):460-467. doi:10.1097/ANC.0000000000000676 Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9(6):281-285. doi:10.1089/bfm.2014.0024

In this episode: National health equity thought leader Jenné Johns discusses how health inequities and implicit bias in the healthcare system impact moms of color and preterm birth rates. She also shares how her own experience in the neonatal intensive care unit (NICU) motivated her to launch a virtual training academy focused on delivering health and racial equity educational programs for healthcare professionals who support the perinatal and neonatal community. Show notes: Once Upon a Preemie Academy Order Jenne's book Once Upon a Preemie Contact Jenne to bring Implicit Bias training to your organization: [email protected]

In this episode: Neonatal nurse Kim Carmignani discusses the evidence regarding the use of an Exclusive Human Milk Diet on reducing the risk of bronchopulmonary dysplasia (BPD) among preterm infants. Show notes: Hair AB, Peluso AM, Hawthorne KM, et al. Beyond necrotizing enterocolitis prevention: improving outcomes with an exclusive human milk-based diet. Breastfeed Med. 2016;11(2):70-74. doi:10.1089/bfm.2015.0134. Published correction appears in Breastfeed Med. 2017;12(10):663. doi:10.1089/bfm.2015.0134.correx Manthe ED, Perks PH, Swanson JR. Team-based implementation of an exclusive human milk diet. Adv Neonat Care. 2019;19(6):460-467. doi:10.1097/ANC.0000000000000676 Hair AB, Bergner EM, Lee ML, et al. Premature infants 750-1250 g birth weight supplemented with a novel human milk-derived cream are discharged sooner. Breastfeed Med. 2016;11(3):133-137. doi:10.1089/bfm.2015.0166 Lapcharoensap W, Bennett MV, Xu X, Lee HC, Dukhovny D. Hospitalization costs associated with bronchopulmonary dysplasia in the first year of life. J Perinatol. 2020;40(1):130-137. doi:10.1038/ s41372-019-0548-x Assad M, Elliott MJ, Abraham JH. Decreased cost and improved feeding tolerance in VLBW infants fed an exclusive human milk diet. J Perinatol. 2016;36(3):216‐220. doi:10.1038/jp.2015.168

In this episode: Registered dietitian Stacia Pegram discusses evidence regarding the use of a human milk caloric fortifier for preterm infant, the role of Prolacta’s human milk caloric fortifier as a part of an Exclusive Human Milk Diet (EHMD) and strategies for maximizing nutrient delivery in an EHMD. Show notes: Learn more about Prolact CR® Prolact CR® Preparation Guidelines Rogers SP, Hicks PD, Hamzo M, Veit LE, Abrams SA. Continuous feedings of fortified human milk lead to nutrient losses of fat, calcium, and phosphorous. Nutrients. 2010;2(3):230-240. doi:10.3390/nu2030240                                                                             Hair AB, Blanco CL, Moreira AG, et al. Randomized trial of human milk cream as a supplement to standard fortification of an exclusive human milk-based diet in infants 750-1250 g birth weight. J Pediatr. 2014;165(5):915-920. doi:10.1016/j.jpeds.2014.07.005 Hair AB, Bergner EM, Lee ML, et al. Premature infants 750-1250 g birth weight supplemented with a novel human milk-derived cream are discharged sooner. Breastfeed Med. 2016;11:133-137. doi:10.1089/bfm.2015.0166 Tabata M, Abdelrahman K, Hair AB, Hawthorne KM, Chen Z, Abrams SA. Fortifier and cream improve fat delivery in continuous enteral infant feeding of breast milk. Nutrients. 2015;7(2):1174-1183. doi:10.3390/nu7021174 Knake LA, King BC, Gollins LA, et al. Optimizing the use of human milk cream supplement in very preterm infants: growth and cost outcomes. Nutr Clin Pract.  doi:10.1002/ncp.10423

In this episode: Scott Eaker describes the stringent screening process for breastmilk donors to become Prolacta donors and how Prolacta’s testing and manufacturing practices provide the safest and highest quality nutritional products for neonatal care.  Show notes: Prolacta's Quality and Safety Manufacturing Video

In this episode: Neonatologist Victoria Niklas, MD discusses the function of human milk oligosaccharides (HMOs) in newborns and their benefit to preterm infant health, the impact of freezing, thawing and pasteurization on HMOs, and the potential of HMOs in future health and wellness uses. Show notes: Tannock GW, Lawley B, Munro K, et al. Comparison of the compositions of the stool microbiotas of infants fed goat milk formula, cow milk-based formula, or breast milk. Appl Environ Microbiol. 2013 May;79(9):3040-8. doi: 10.1128/AEM.03910-12Sullivan S, Schanler RJ, Kim JH, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156(4):562-567. doi:10.1016/j.jpeds.2009.10.040Hair AB, Peluso AM, Hawthorne KM, et al. Beyond necrotizing enterocolitis prevention: improving outcomes with an exclusive human milk-based diet. Breastfeed Med. 2016;11(2):70-74. doi:10.1089/bfm.2015.0134Ruhaak LR, Stroble C, Underwood MA, Lebrilla CB. Detection of milk oligosaccharides in plasma of infants. Anal Bioanal Chem. 2014;406(24):5775-5784. doi:10.1007/s00216-014-8025-zWang B. Molecular mechanism underlying sialic acid as an essential nutrient for brain development and cognition. Adv Nutr. 2012 May 1;3(3):465S-72S. doi: 10.3945/an.112.00187Jacobi SK, Yatsunenko T, Li D,et al. Dietary isomers of sialyllactose increase ganglioside sialic acid concentrations in the corpus callosum and cerebellum and modulate the colonic microbiota of formula-fed piglets. J Nutr. 2016 Feb;146(2):200-8. doi: 10.3945/jn.115.220152Bode L. Human milk oligossacharides in the prevention of necrotizing enterocolitis: a journey from in vitro and in vivo models to mother-infant cohort studies. Front Pediatr. 2018 Dec 4;6:385. doi: 10.3389/fped.2018.00385Wejryd E, Marti M, Marchini G, et al. Low diversity of human milk oligosaccharides is associated with necrotizing enterocolitis in extremely low birth weight infants. Nutrients. 2018 Oct 20;10(10). pii: E1556. doi: 10.3390/nu10101556

In this episode: NICU Nurse Amy Paradis discusses best practices for effectively and accurately measuring growth of premature infants in the NICU Show notes: NICU Nutrition Calculator App (iphone)Peditools.org to access Fenton 2013 Growth Chart, WHO Growth Chart, and Zemel Growth ChartCalifornia Perinatal Quality Care Collaborative Grow, Babies, Grow Toolkit

In this episode: Dena L. Goldberg, PhD, RDN discusses the importance of identifying malnutrition in preterm infants and neonates and its role in improving clinical outcomes.  Show notes: Becker P, Carney LN, Corkins MR, et al. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition). Nutr Clin Pract. 2015 Feb;30(1):147-61. doi: 10.1177/0884533614557642 Goldberg DL, Becker PJ, Brigham K, et al. Identifying malnutrition in preterm and neonatal populations: recommended indicators. J Acad Nutr Diet. 2018 Sep;118(9):1571-1582. doi: 10.1016/j.jand.2017.10.00

In this episode: Dr. Martin Lee discusses the earliest research on the importance of human milk in the preterm population and the story behind the development of the first and only 100% human milk-based fortifier for micropreemies. Show notes: Sullivan S, Schanler RJ, Kim JH, et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr. 2010;156(4):562-567. doi:10.1016/j.jpeds.2009.10.040 Modanlou HD, Lim MO, Hansen JW, Sickles V. Growth, biochemical status, and mineral metabolism in very-low-birth-weight infant.J Pediatr Gastroenterol Nutr. 1986 Sep-Oct;5(5):762-7. doi:10.1097/00005176-198609000-00017 Cristofalo EA, Schanler RJ, Blanco CL, et al. Randomized trial of exclusive human milk versus preterm formula diets in extremely premature infants. J Pediatr. 2013;163(6):1592-1595. doi:10.1016/j.jpeds.2013.07.011 Abrams SA, Schanler RJ, Lee ML, Rechtman DJ. Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products. Breastfeed Med. 2014;9(6):281-285. doi:10.1089/bfm.2014.0024