Universität zu Köln

Keller, Titus, Koerber, Friederike, Oberthuer, Andre, Schafmeyer, Leonie, Mehler, Katrin, Kuhr, Kathrin and Kribs, Angela (2019). Intranasal breast milk for premature infants with severe intraventricular hemorrhagean observation. Eur. J. Pediatr., 178 (2). S. 199 - 207. NEW YORK: SPRINGER. ISSN 1432-1076

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Abstract

For nasal application of neurotrophins and mesenchymal stem cells, successful delivery to the brain and therapeutic effects are known from experimental data in animals. Human breast milk contains neurotrophins and stem cells, but gavage tube feeding in preterm infants bypasses the naso-oropharynx. This is a first exploration on additional nasal breast milk and neuromorphological outcome after severe neonatal brain injury. We present a retrospective summary of 31 very low birth weight preterm infants with intraventricular hemorrhage degrees 3/4 from one third-level neonatal center. All were breast milk fed. Sixteen infants additionally received nasal drops of fresh breast milk daily with informed parental consent for at least 28days. Cerebral ultrasound courses were reviewed by a pediatric radiologist blinded to the intervention. The main outcome measure was severity of porencephalic defects before discharge. Clinical covariates were comparable in both groups. With nasal breast milk, a trend to a lower incidence for severe porencephalic defects (21% vs. 58%) was detected. Incidences were lower for progressive ventricular dilatation (71% vs. 91%) and surgery for posthemorrhagic hydrocephalus (50% vs. 67%).Conclusion: The hypothesis is generated that early intranasal application of breast milk could have a beneficial effect on neurodevelopment in preterm infants. Controlled investigation is needed.What is Known:center dot Successful delivery to the brain and therapeutic effects are known for nasal application of neurotrophins and mesenchymal stem cells from experimental data in animal studies.center dot Human breast milk contains neurotrophins and stem cells, but gavage tube feeding in preterm infants bypasses the naso-oropharynx.What is New:center dot This is the first report on additional nasal breast milk application in very low birth weight preterm infants with severe brain injury observing a trend for less severe porencephalic defects.center dot The hypothesis is generated that nasal breast milk might exert neuroprotective effects in preterm infants.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Keller, Titus UNSPECIFIED UNSPECIFIED UNSPECIFIED Koerber, Friederike UNSPECIFIED UNSPECIFIED UNSPECIFIED Oberthuer, Andre UNSPECIFIED UNSPECIFIED UNSPECIFIED Schafmeyer, Leonie UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehler, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-158471
DOI:	10.1007/s00431-018-3279-7
Journal or Publication Title:	Eur. J. Pediatr.
Volume:	178
Number:	2
Page Range:	S. 199 - 207
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1076
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTELLIGENCE QUOTIENT; PRETERM INFANTS; BRAIN-INJURY; LACTOFERRIN; INSULIN; MEMORY Multiple languages Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15847