Comparison of Two Pumping Strategies to Improve Exclusive Breastfeeding at Discharge in Mothers of VLBW Infants with Low Milk Output - A Pilot Randomized Controlled Trial.

OBJECTIVES: To compare the effect of two strategies of breast pumping -power pumping (PP) vs. routine pumping (RP) over one week in mothers of very low birth weight (VLBW) infants with low milk output to improve breastfeeding rates at discharge. METHODS: Mothers with low milk output, defined as inability to express sufficient breastmilk to meet the feeding requirements of their infant on or after post-natal day 14, were randomized to receive power pumping vs. routine pumping - once daily for 7 d coupled with routine lactation support and hand expression 3 hourly in both groups. The primary outcome was exclusive breastfeeding at discharge. RESULTS: There was no difference in the two pumping strategies with respect to exclusive breastfeeding rates [61.1% in PP vs. 50% in RP group; (p = 0.477, RR 1.2; 95% CI 0.76 to 2.17)]. Median milk volume pumped in the individual power pumping session on 7th day of intervention was significantly higher than that in the individual routine pumping session on the 7th day (50 mL vs. 27 mL, p = 0.014). The cumulative median milk volume expressed per individual pumping session over the 7 sessions of power pumping was also higher than that with routine pumping (305 mL vs. 213 mL, p = 0.054). CONCLUSIONS: In this pilot trial, expressed milk volume was significantly higher after each individual power pumping session compared to routine pumping. However, the exclusive breastfeeding rates at discharge were similar in the two groups.

The dilemma of feeding during the treatment of patent ductus arteriosus with oral ibuprofen in preterm infants ≤30 weeks of gestation-a randomized controlled trial.

OBJECTIVES: To evaluate the effect of minimal enteral feeding (MEN) versus withholding feeding on time to reach full feeds during treatment of hs-PDA with oral ibuprofen in infants ≤30 weeks. STUDY DESIGN: We performed a single-center, randomized control trial of 126 premature infants born ≤30 weeks gestation, <7 days of age with hs-PDA comparing continuation of MEN (n = 64) vs no feeding (n = 62) during treatment. The primary outcome was time to reach a feed volume of 150 ml/kg/day. Secondary outcomes included were episodes of feed intolerance, GI bleed, NEC and other comorbidities. RESULTS: There was no difference in the time to reach full feeds - median age of 16 days in both groups (p = 0.573). Incidence of feed intolerance, NEC and other secondary outcomes were also similar in both groups. CONCLUSIONS: Continuing MEN during treatment of hs-PDA with oral ibuprofen does not decrease time to reach full enteral feeds in very preterm infants.

Citrus processing by-products: an overlooked repository of bioactive compounds.

Citrus fruits contain plethora of bioactive compounds stored in edible as well as inedible part. Since, citrus fruits are processed mainly for juice, the residues are disposed in wastelands, hence, plenty of nutritional potential goes in vain. But if utilized wisely, the bioactive phytochemicals in citrus by-products have the ability to revolutionize the functional food industry. In the present review, the composition of citrus by-products in terms of bioactive components and their health benefits has been reviewed. Various extraction techniques used to extract these bioactives has been discussed and a brief overview of purification and utilization of the extracted compounds, in food and nutraceutical industry is also presented. Bioactives in citrus by-products are higher than the peeled fruit, which can be extracted, isolated and incorporated into food systems for development of health foods. From the studies reviewed, it was observed that research reported on utilization of citrus by-products is limited to mainly research labs; proper scale-up process and its adequate research commercialization is the need of hour to transform these bioactives into economical functional ingredients.

Gluten-free grains: Importance, processing and its effect on quality of gluten-free products.

Gluten-enteropathy affects a significant number of people, making gluten a major concern in the food industry. With medical advancements, the diagnosis of allergies is becoming easier, and people who are allergic to gluten are recommended a complete gluten-free diet. Since wheat provides a major part of the energy and nutrition in the diet, its elimination affects nutrition intake of allergic population. Food scientists are working to formulate products using protein-rich gluten-free grains with quality attributes at par with gluten-containing products. Focused research has been done to provide nutrition and a variety of food to people suffering from gluten-related disorders. Efforts are being made to remove the gluten from the wheat and other gluten-containing grains, while applying different processing/treatments to enhance the properties of gluten-free grains. Hence, the present review summarizes the importance, processing, and products of different gluten-free grains. It also highlights the digestibility of gluten-free grains with clinical trials and gluten elimination strategies for gluten-containing grains.

Cultivation of microalgae on food waste: Recent advances and way forward.

Microalgae are photosynthetic microbes that can synthesize compounds of therapeutic potential with wide applications in the food, bioprocessing and pharmaceutical sector. Recent research advances have therefore, focused on finding suitable economic substrates for the sustainable cultivation of microalgae. Among such substrates, food derived waste specifically from the starch, meat, dairy, brewery, oil and fruit and vegetable processing industries has gained popularity but poses numerous challenges. Pretreatment, dilution of waste water supernatants, mixing of different food waste streams, utilizing two-stage cultivation and other biorefinery approaches have been intensively explored for multifold improvement in microalgal biomass recovery from food waste. This review discusses the advances and challenges associated with cultivation of microalgae on food waste. The review suggests that there is a need to standardize different waste substrates in terms of general composition, genetically engineered microalgal strains, tackling process scalability issues, controlling wastewater toxicity and establishing a waste transportation chain.