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1.
Acta Clinica Croatica ; 61(4):681-691, 2022.
Article in English | EMBASE | ID: covidwho-20241447

ABSTRACT

Ever since the beginning of COVID-19 pandemic, uncertainty regarding clinical presentation and differences among various subpopulations exist. With more than 209,870,000 confirmed cases and more than 4,400,000 deaths worldwide, we are facing the new era of health crisis which will undoubtedly impair global health, economic and social circumstances. In the past year, numerous genetic mutations which code SARS-CoV-2 proteins led to the occurrence of new viral strains, with higher transmission rates. Apart from the implementation of vaccination, the effect of SARS-CoV-2 on pregnancy outcome and maternal fetal transmission remains an important concern. Although neonates diagnosed with COVID-19 were mostly asymptomatic or presented with mild disease, the effect on early pregnancy is yet to be evident. While positive finding of SARS-CoV-2 RNA in some samples such as amniotic fluid, placental tissue, cord blood and breast milk exists, additional research should confirm its association with transplacental transmission.Copyright © 2022, Dr. Mladen Stojanovic University Hospital. All rights reserved.

2.
American Journal of Reproductive Immunology ; 89(Supplement 1):54, 2023.
Article in English | EMBASE | ID: covidwho-20236532

ABSTRACT

Cumulative data regardingCOVID-19 infection during pregnancy have demonstrated the ability of SARS-CoV-2 to infect the placenta. However, the mechanisms of SARS-CoV-2 placental viral entry are yet to be defined. SARS-CoV-2 infects cells by binding to the ACE2 receptor. However, SARS-CoV-2 cell entry also requires co-localization of spike protein cleavage by the serine protease TMPRSS2. However, the co-expression of ACE2 and TMPRSS2 in placental cells is debated, raising the question of whether potential non-canonical molecular mechanismsmay be involved in SARS-CoV-2 placental cells' viral entry. Although published data regarding the ability of the SARS-CoV- 2 to infect the fetus are contradicting, the placenta appears to be an immunological barrier to active SARS-CoV-2 infection and vertical transmission;however, the mechanism is unclear. Our experiments demonstrated the ability of the SARS-CoV-2 virus to directly infect the placenta and induce transcriptomic responses in COVID-positive mothers. These transcriptomic responses were characterized by differential expression of specific mRNAs and miRNAs associated with SARS-CoV-2 infection, with induction of specific placental miRNAs that can inhibit viral replication. Failure in such mechanisms may be associated with vertical transmission. Since the start of the COVID-19 pandemic, the COVID-19 mRNA vaccines have been widely used to reduce the morbidity and mortality of SARS-CoV-2 infection. Historically, non-live vaccines have not caused any harm to pregnant mothers;however, it is unclear whether our current understanding of the effects of non-live vaccines serves as a reliable precedent owing to the novel technology used to create these mRNA vaccines. Since there are no definitive data on the possible biodistribution of mRNA vaccines to the placenta, the likelihood of vaccine mRNA reaching the fetus remains uncertain. Little has been reported on the tissue localization of the lipid nanoparticles (LNPs) after intramuscular (IM) administration of the mRNA vaccine. The biodistribution of LNPs containing the mRNA vaccine has been investigated in animal models but not humans. In the murine model, the vaccine LNPs were rapidly disseminated to several organs, including the heart, liver, kidney, lung, and spleen, following IM administration. However, no traditional pharmacokinetic or biodistribution studies have been performed with the mRNA vaccines, including possible biodistribution to breast milk or the placenta.

3.
Journal of SAFOG ; 15(2):226-230, 2023.
Article in English | EMBASE | ID: covidwho-20236388

ABSTRACT

Ab s t r ac t Aim: The aim of this study was to summarize different types of benefits that have been observed in the baby's development and the mother's psychological health during the postpartum period. Background(s): Breastfeeding is a natural process that plays a vital role in the physical as well as mental health of the mother and child. Breast milk is rich in contents such as proteins, fats, and vitamins, which are responsible for building the immune system of the baby. Lactation helps in decreasing the prevalence of infant mortality rate. It enhances the development of the physical health of the children. Breastfeeding protects the mother from many systemic conditions like endometrial cancer, ovarian cancer, breast cancer, etc. It has been observed that with an increase in healthy breastfeeding practices, there is a decline in the cases of maternal mental health issues reported mainly in the postpartum period. Review result: The authors have explained various types of advantages of breastfeeding on the child's and mother's health, their mechanism of action, effects on the baby, and mother-child relationship. Conclusion(s): The mother's mental health plays a crucial role in a healthy infant, and breastfeeding is key to it. The role of breastfeeding is therefore considered a boon for the mother because if there is a decrease in health issues in the child, the mother's mental condition improves automatically. Therefore, breastfeeding should be promoted at the national level. Clinical significance: Breastfeeding not only helps in reducing maternal stress and postpartum depression but also improves the physical health of the child and mother during the postpartum period. The clinicians should teach mothers about the importance and also the correct positions of breastfeeding. "Breastfeeding week" is celebrated every year from August 1 to August 7, as implemented by the Indian government.Copyright © The Author(s). 2023 Open Access.

4.
Paediatria Croatica ; 64(2):103-110, 2020.
Article in Croatian | EMBASE | ID: covidwho-20236109

ABSTRACT

Donated human milk is the best substitute for breast milk in the case when the mother cannot feed her baby. Human milk banks provide safe and high quality donated human milk. That was the reason why the Human Milk Bank was established in the Croatian Tissue and Cell Bank at the Zagreb University Hospital Centre in January 2020. The Bank works in accordance with the Law on the Application of Human Tissues and Cells. In this paper, we present the results of the Bank work since from its opening until June 2020. Due to logistic reasons caused by the COVID-19 epidemic and the earthquake in Zagreb, the Human Milk Bank did not collect milk for 43 days. Milk was donated by 31 mothers. Their median age was 31 years and 81% of them had high education level. In 52% of cases, mothers started donating milk three months after giving birth. Most donors donated milk only once (45%). The median period of donation was 46 days. The majority (52%) of donors gave birth for the first time, in the expected term of childbirth (94%), birth weight was >2500 g. Only three of donors' children (9%) were in intensive care. A total of 175.5 L of milk were collected (mean 5.7 L per donor), of which 151.5 L met the requirements of input quality control, and 141 L were pasteurized. A critical number of viable aerobic and facultative bacteria were identified in 32.6% of milk pools prepared for pasteurization, and 8.9% after pasteurization. For clinical use, 78.7 L were dispensed in three neonatal intensive care units. The Human Milk Bank has already shown the importance of its activities during the first months of operation. In order to be able to meet the needs for donated human milk at the national level, it is necessary to constantly inform mothers about the importance of human milk and to promote its donation.Copyright © 2020 Croatian Paediatric Society. All rights reserved.

5.
VirusDisease ; 34(1):105, 2023.
Article in English | EMBASE | ID: covidwho-2317614

ABSTRACT

Background: Coronavirus disease-2019 (COVID-19) has rapidly disseminated worldwide, with a wide variety of clinical manifestations ranging from mild respiratory symptoms to severe pneumonia. Since then, there have been over 62300396 cases of COVID-19 infections worldwide, with 6550033 deaths. Coronavirus disease has presented the world to uncertainty and clinical dilemma with developing and constantly changing management guidelines and protocols. In the backdrop of this pandemic, it thus becomes crucial to study the effects of the infection on pregnancy, childbirth, and the postpartum period. In this study, we analyzed experiences of breastfeeding mothers during the COVID-19 pandemic, specifically concerning how COVID-positive status affected their infant's feeding decisions. Objective(s): To study anxiety, fear and depression associated with breastfeeding in coronavirus disease (COVID)-positive mothers. Method(s): The following DASS scale was used to measure depression anxiety, and stress of coronavirus disease-2019 (COVID-19) among postpartum women along with a self-made breastfeeding questionnaire to assess the association with breastfeeding. Result(s): Among the total of 77 respondents, 13% showed symptoms of depression, 16% anxiety and 9% stress. The breastfeeding questionnaire suggested that most women are afraid of transmitting the infection to their newborns and they lack the knowledge about the importance of breast milk in warding off other infections. Also, women found it difficult to take care of their newborns on their own. Conclusion(s): With this study, we could determine the effects of this pandemic on anxiety depression, and stress levels of COVID infection in postpartum women. It clearly showed that being COVID positive created, affected, and exacerbated mental health issues for mothers. So, there is an urgent need to provide emotional and psychosocial support to this group of the population during the crisis. Otherwise, the adverse outcome is possible involving both mother and newborn.

6.
Journal of Biological Chemistry ; 299(3 Supplement):S399, 2023.
Article in English | EMBASE | ID: covidwho-2315554

ABSTRACT

Breast milk is generally accepted as the perfect source of nutrition for the health and development of infants. It also assists in infant innate and adaptive immunity through many proteins that are decorated with glycans. Examples of these glycoproteins include IgA, IgG, and innate immune lectins. Maternal diet and environmental exposure such as pathogens and pollutants affect human milk composition including its glycoprofile. Despite altered glycosylation can have a consequence on the nursing infant's health and immunity, the current knowledge is still emerging in this area of study. COVID-19 has gained attention in recent years by causing severe morbidity and mortality. Similar to other infectious diseases such as influenza, our lab recently revealed alterations in glycome of plasma and different tissue samples of COVID-19 infected patients. Inspired by these findings, we are interested in disclosing the effect of SARS-CoV-2 on glycosylation of breast milk proteins. Toward this, we performed a large-scale systematic study using our high-throughput lectin microarray analysis technology. We analyzed 132 control samples (breast milk collected pre- COVID) and breast milk from 78 COVID-19 infected mothers. Our data showed there is a 4-fold increase in -2,3 sialic acid on glycoproteins that is associated with SARS-CoV-2 infection in lactating mothers. Lectin pulldown experiments further testified to these findings. Given the significance of -2,3 sialic acid glycan signature in infectious diseases, our finding could provide valuable insight into therapeutic development.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.

7.
Revista Espanola de Salud Publica ; 96(e202210059), 2022.
Article in Spanish | CAB Abstracts | ID: covidwho-2315057

ABSTRACT

The human milk donation has been an undervalued and very biasedly examined subject until relatively recently, in comparison with other types of human donation (organs, tissues, fluids), not being recognized its dimension of bodily altruistic and philanthropic act in the same way as other (mildly) analogous realities, as well as in its approach from the perspective of feminist and gender studies. On the other hand, although the COVID-19 pandemic and the various lockdown processes have had an onerous impact on human breastfeeding in general, we find data on the global increase in breastfeeding donation as a specific altruistic gesture during the pandemic in Spain and, even, on the decisions in the most complicated moments of the state of alarm about donating one's own milk in the tragedy of perinatal death. These altruistic donations contribute to carrying out the fulfillment of what has already been declared a human right and one of the social investments with the most advantageous cost-benefit index. The recognized, intensified and amplified need for milk banks in a pandemic brings to the fore in a specific way the condition of human milk as capital physiological resource, and, ultimately, as a global good. This article is dedicated to delving into a critical hermeneutics of milk donation in light of the pandemic and as an opportunity to rethink the studies of recent decades in this regard.

8.
Birth ; 2022 Jul 08.
Article in English | MEDLINE | ID: covidwho-2316997

ABSTRACT

INTRODUCTION: Pregnant women are vulnerable to severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. Neutralizing antibodies against the SARS-CoV-2 spike (S) protein protect from severe disease. This study analyzes the antibody titers to SARS-CoV-2 S protein in pregnant women and their newborns at delivery, and six months later. METHODS: We conducted a prospective study on pregnant women with confirmed SARS-CoV-2 infection and newborns. Antibody (IgG, IgM, and IgA) titers were determined using immunoassays in serum and milk samples. An angiotensin-converting enzyme 2 (ACE2) receptor-binding inhibition assay to the S protein was performed on the same serum and milk samples. RESULTS: At birth, antibodies to SARS-CoV-2 spike protein were detected in 81.9% of mothers' sera, 78.9% of cord blood samples, and 63.2% of milk samples. Symptomatic women had higher antibody titers (IgG, IgM, and IgA) than the asymptomatic ones (P < 0.05). At six months postpartum, IgG levels decreased drastically in children's serum (P < 0.001) but remained high in mothers' serum. Antibody titers correlated positively with its capacity to inhibit the ACE2-spike protein interaction at baseline in maternal sera (R2  = 0.203; P < 0.001), cord sera (R2  = 0.378; P < 0.001), and milk (R2  = 0.564; P < 0.001), and at six months in maternal sera (R2  = 0.600; P < 0.001). CONCLUSIONS: High antibody levels against SARS-CoV-2 spike protein were found in most pregnant women. Due to the efficient transfer of IgG to cord blood and high IgA titers in breast milk, neonates may be passively immunized to SARS-CoV-2 infection. Our findings could guide newborn management and maternal vaccination policies.

10.
European Research Journal ; 9(3):536-542, 2023.
Article in English | Academic Search Complete | ID: covidwho-2301526

ABSTRACT

Objectives: In this study, besides the factors affecting breastfeeding, such as the tendency to breastfeed, the number of children, educational status, maternal age, working style, it was investigated how the breastfeeding behavior was affected during the epidemic. Methods: At least 384 mothers were included in the study with a 95% confidence level, 0.05 margin of error, and 403 mothers were included in the study. A questionnaire form prepared by the researchers was used as a data collection tool and consent form was obtained from the participants. Results: The mean age of the mothers participating in the study was 29.2 ± 5.9 years (range:18 to 52 years). Two hundred and one (49.8%) mothers participating in the study do not find it safe for mothers with COVID-19 to breastfeed their baby. However, only 20.2% of mothers think that COVID-19 can be transmitted to the baby through breast milk. Ninety-eight (24.4%) mothers stated that they could breastfeed their babies even if they had COVID-19, and 15.5% stated that mothers with COVID-19 around them could breastfeed their babies. Conclusions: Although the COVID-19 epidemic had a negative impact on all aspects of life globally, it did not generally change the breastfeeding decisions of breastfeeding mothers. In fact, due to the closures and extended maternity leave, mothers spent more time with their babies and enabled them to breastfeed more frequently. However, it should not be neglected that misinformation is at a substantial level. In the studies conducted, wrong or incomplete information was observed in a significant part of the mothers who did not consider breastfeeding due to the epidemic, although the rates were low. For this reason, besides health professionals, media organs should be actively used for information. [ FROM AUTHOR] Copyright of European Research Journal is the property of Prusa Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

11.
Vaccines (Basel) ; 11(4)2023 Apr 07.
Article in English | MEDLINE | ID: covidwho-2301527

ABSTRACT

We aimed to determine the attitudes and behaviors of breastfeeding mothers regarding the vaccine by examining their knowledge of the COVID-19 virus vaccine and their hesitations about it. The research is a cross-sectional and descriptive study conducted in the Kahta district of Adiyaman, a southeastern province in Turkey, between January and May 2022. The study population consisted of 405 mothers who applied to the Kahta State Hospital Pediatrics outpatient clinic. A questionnaire form was used as a data collection tool, and a consent form was obtained from the participants. The vaccination rate (89%) of those who graduated from high school and above was significantly higher than that of those who graduated from secondary school or below (77.7%). As the economic situation worsened, the vaccination rate decreased. The vaccination rate (85.7%) of mothers whose breastfed child was 0-6 months old was found to be significantly higher than that of those with 7-24-month-olds (76.4%) (p:0.02). The rate of being vaccinated (73.3%) of those who had a new type of COVID-19 virus infection was significantly lower than the rate of being vaccinated (86.3%) of those who did not have a COVID-19 virus infection. The vaccination rate of those who received information from their family doctor and the internet was higher than that of those who received information from radio/TV and people around. The rate of mothers thinking babies should stop breastfeeding who graduated from secondary school or below was higher (53.2%) than the rate of mothers who graduated from high school or above (30.2%) to be vaccinated against the COVID-19 virus. To eliminate the hesitancy about vaccination in mothers, it is necessary to inform and educate the whole society correctly, starting with families with low education and economic levels.

12.
Neonatal Intensive Care ; 35(1):45-48, 2022.
Article in English | EMBASE | ID: covidwho-2277717
13.
Journal of Cardiovascular Disease Research ; 13(7):716-724, 2022.
Article in English | CAB Abstracts | ID: covidwho-2261748

ABSTRACT

Background: High risk of COVID-19 infection is reported in neonates of COVID-19-affected females along with adverse effects secondary to the infection. Limited work in literature is done on COVID-19 infection transmission from affected females to neonates born to them with few studies reporting vertical transmission of COVID-19. Aim: To evaluate SARS-CoV-2 vertical or perinatal transmission and describe neonatal clinical findings and short-term outcomes in babies born to Covid- 19 positive mothers. Methods: The study assessed 19 females and 19 neonates. All neonates immediately after birth were breastfed and kept with the mother in cases with the clinically stable situation for babies and mothers both. For all the babies, nasal swab samples were sent to detect SARS-CoV-2 on day 1 of their birth. The neonates were followed for 7-14 days after their birth followed by reassessment for SARS-CoV-2 from nasal swab specimens. Results: All babies were healthy with no detection of SARS-CoV-2 seen from the neonates from the nasopharyngeal swabs. Also, no separation was done from mothers, and breastfed was given to all the neonates which showed no transmission of SARS-CoV-2 from breast milk to the neonates. Conclusion: Benefits of breastfeeding are higher compared to the risk of perinatal or vertical transmission depicting that there is no need for separation of the neonate from SARS-CoV-2 positive mothers. Also, neonates can be breastfed from COVID-19-positive mothers without the risk of virus transmission.

14.
Annals of Nutrition and Metabolism Conference: Ibero American Nutrition Foundation Congress, FINUT ; 79(1), 2022.
Article in English | EMBASE | ID: covidwho-2249768

ABSTRACT

The proceedings contain 343 papers. The topics discussed include: alterations in the gut microbiota associated with obesity and metabolic disease: cause or consequence?;childhood obesity in the community context;big data and machine learning as tools for the biomedical field;thermogenesis and adipose tissue: effect of genistein;pediatric obesity and comorbidities: a question of time and genetics? the Portuguese experience;nutrigenomics of inflammation;environmental factors associated with school children's excess of weight in communities of Costa Rica;dietary consumption: guided by a focus of nutrient adequacy or selection of foodstuffs?;functional foods as key regulators of gut microbiota in the SARS-CoV-2 infection;immunomodulatory properties of human milk;vitamin d in childhood and adolescent obesity;and new sources of vitamin D and E supplementation during pregnancy.

15.
Gynakologie ; 55(9):654-659, 2022.
Article in German | EMBASE | ID: covidwho-2283384

ABSTRACT

Vaccinations are one of the greatest achievements for protecting public health. Vaccines given to pregnant women protect not only the pregnant woman, but also the newborn. Pregnant women are disproportionately strongly affected by infections. The conflicting demands on the maternal immune system during pregnancy geared toward maintaining fetal immune tolerance make a rapid and effective immune response against pathogens more difficult. This dynamic state of immune adaptation predisposes pregnant women to more severe disease progression. Vaccination can prevent infection or a serious course of disease. As a result, the risk of premature birth and other serious pregnancy complications that can have lifelong consequences for both mother and child also decreases. After birth, when the newborn must first develop an adaptive memory for a hitherto unknown, antigen-rich environment, it is particularly vulnerable to infections and resulting complications. The transfer of maternal antibodies across the placenta protects infants who are too young to be vaccinated. When breastfeeding, this continues through antibodies in breast milk. For the vaccinations recommended by the Standing Vaccination Committee (STIKO) during pregnancy (influenza, pertussis, coronavirus disease [COVID]-19), there is clear evidence from various observational and prospective studies that they protect mother and child either from infection or from a severe disease course. The following article gives an overview of the vaccination strategy for pregnancy and summarizes the scientific data on effectiveness of the vaccinations currently recommended during pregnancy.Copyright © 2022, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

16.
Curr Diabetes Rev ; 19(3): e260422204030, 2023.
Article in English | MEDLINE | ID: covidwho-2261467

ABSTRACT

BACKGROUND: Breastfeeding maintains the maternal-fetal immune link after birth, favors the transmission of immunological competence, and is considered an important contributing factor to the development of the babies' immune system. OBJECTIVE: This study aimed to obtain data related to the effects of gestational diabetes on immunoglobulin A (IgA) and cytokines levels in the colostrum, before and during the pandemic of the new coronavirus, in order to study the possible outcomes regarding the immunological characteristics of human milk. METHODS: This systematic review was registered in PROSPERO CRD42020212397, and the question elaborated using the PICO strategy was: does maternal hyperglycemia associated or not with Covid-19 influence the immunological composition of colostrum? Electronic searching and reference lists of published reports were used to identify studies that reported the influence of gestational diabetes on colostrum and milk composition. RESULTS: Seven studies were selected from the 51 found, six of them were cross-sectional and one was a case report. Six studies included Brazilian groups and only one was conducted in USA. The mothers with gestational diabetes presented a reduced level of IgA and other immunoreactive proteins in colostrum. Those alterations could be related to changes in macronutrient metabolism and cellular oxidative metabolism. CONCLUSION: It was possible to conclude that diabetes changes the immunological composition of breast milk; however, data on the impact of the association between gestational diabetes and Covid-19 infection on the composition of antibodies and cytokines present in human milk are still scarce and inconclusive.


Subject(s)
COVID-19 , Diabetes, Gestational , Pregnancy , Infant , Female , Humans , Colostrum/metabolism , Cytokines , Pandemics , COVID-19/metabolism , Immunoglobulin A/metabolism
17.
World J Pediatr Congenit Heart Surg ; 14(3): 300-306, 2023 05.
Article in English | MEDLINE | ID: covidwho-2260560

ABSTRACT

Background: Breast milk is known to prevent infections and is recommended for enteral feeding of infants after congenital heart surgery (CHS). During the Covid-19 pandemic, expressed breast milk (EBM) was not always available; hence, feeding after CHS was maintained with EBM or infant formula (IF) or both; we evaluated the impact of enteral feed type on early postoperative outcomes after CHS. Methods: In a prospective observational study, consecutive neonates and infants <4 months undergoing CHS were divided into EBM, IF, or EBM+IF groups; incidences of postoperative infections, ventilation duration, intensive care unit (ICU) stay, and mortality were studied. Results: Among 270 patients; 90 (33.3%) received EBM, 89 (32.9%) received IF, and 91 (33.7%) received EBM+IF. IF group had more neonates (78.7%[IF] vs 42.2%[EBM] and 52.7%[EBM+IF], P < 0.001) and greater surgical complexity. Postoperative infections were 9 (10.0%) in EBM; 23 (25.8%) in IF; and 14 (15.4%) in EBM+IF (P = .016). IF group (OR 2.58 [1.05-6.38], P = .040), absence of preoperative feeding (OR 6.97 [1.06-45.97], P = .040), and increase in cardiopulmonary bypass time (OR 1.005 [1.001-1.010], P = .027) were associated with postoperative infection. Ventilation duration in hours was 26 (18-47.5) in EBM; 47 (28-54.5) in IF; and 40 (17.5-67) in EBM+IF (P = .004). ICU stay in days was 4 (3-7) in EBM; 6 (5-9) in IF; and 5 (3-9) in EBM+IF (P = .001). Mortality did not differ (P = .556). Conclusion: IF group had a greater proportion of neonates with higher surgical complexity. Patients who received EBM after CHS had fewer postoperative infections and better postoperative outcomes compared to those receiving IF or EBM+IF.


Subject(s)
COVID-19 , Heart Defects, Congenital , Infant, Newborn , Female , Infant , Humans , Enteral Nutrition , Pandemics , Milk, Human , Heart Defects, Congenital/surgery
18.
Front Nutr ; 10: 1155901, 2023.
Article in English | MEDLINE | ID: covidwho-2256850
19.
Rural Remote Health ; 23(1): 8088, 2023 01.
Article in English | MEDLINE | ID: covidwho-2272243

ABSTRACT

BACKGROUND AND AIMS: Breastfeeding practices have demonstrated a protective effect against severe respiratory syncytial virus (RSV) disease outcomes. RSV is the principal cause of lower respiratory tract infections in infants worldwide, and an important cause of morbidity, hospitalization, and mortality. The primary aim is to determine the impact of breastfeeding on the incidence and severity of RSV bronchiolitis in infants. Secondly, the study aims to determine if breastfeeding contributes to reduction of hospitalization rates, length of stay and oxygen use in confirmed cases. METHODS: A preliminary database search was conducted using agreed keywords and MeSH headings in MEDLINE, PubMed, Google Scholar, EMBASE, MedRχiv and Cochrane Reviews. Articles were screened based on inclusion/exclusion criteria for infants aged 0-12 months. Full text, abstract and conference articles published in English were included from 2000 to 2021. Covidence® software was used for evidence extraction using paired investigator agreement and PRISMA guidelines were followed. RESULTS: 1368 studies were screened and 217 were eligible for full text review. 188 were excluded. Twenty-nine articles were selected for data extraction: RSV-bronchiolitis (18) and viral bronchiolitis (13), with two articles discussing both. Results showed that non-breastfeeding practices are a significant risk factor for hospitalization. Exclusive breastfeeding for >4-6 months significantly lowered admission rates, length of stay and supplemental oxygen use, reducing unscheduled GP visits and emergency department presentation. DISCUSSION: Exclusive and partial breastfeeding reduce severity of RSV bronchiolitis, length of hospital stay and supplemental oxygen requirement. Breastfeeding practices should be supported and encouraged as a cost-effective method to prevent infant hospitalization and severe bronchiolitis infection.


Subject(s)
Bronchiolitis , Respiratory Syncytial Virus Infections , Female , Infant , Humans , Breast Feeding , Incidence , Respiratory Syncytial Virus Infections/epidemiology , Respiratory Syncytial Virus Infections/prevention & control , Hospitalization , Bronchiolitis/epidemiology , Respiratory Syncytial Viruses , Oxygen
20.
Int J Mol Sci ; 24(5)2023 Feb 23.
Article in English | MEDLINE | ID: covidwho-2248209

ABSTRACT

Although only 0.8-1% of SARS-CoV-2 infections are in the 0-9 age-group, pneumonia is still the leading cause of infant mortality globally. Antibodies specifically directed against SARS-CoV-2 spike protein (S) are produced during severe COVID-19 manifestations. Following vaccination, specific antibodies are also detected in the milk of breastfeeding mothers. Since antibody binding to viral antigens can trigger activation of the complement classical - pathway, we investigated antibody-dependent complement activation by anti-S immunoglobulins (Igs) present in breast milk following SARS-CoV-2 vaccination. This was in view of the fact that complement could play a fundamentally protective role against SARS-CoV-2 infection in newborns. Thus, 22 vaccinated, lactating healthcare and school workers were enrolled, and a sample of serum and milk was collected from each woman. We first tested for the presence of anti-S IgG and IgA in serum and milk of breastfeeding women by ELISA. We then measured the concentration of the first subcomponents of the three complement pathways (i.e., C1q, MBL, and C3) and the ability of anti-S Igs detected in milk to activate the complement in vitro. The current study demonstrated that vaccinated mothers have anti-S IgG in serum as well as in breast milk, which is capable of activating complement and may confer a protective benefit to breastfed newborns.


Subject(s)
COVID-19 , SARS-CoV-2 , Infant, Newborn , Infant , Female , Humans , COVID-19 Vaccines , Lactation , Milk, Human , Complement System Proteins , Immunoglobulin G , Antibodies, Viral
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