Breastmilk donations: Bacteriological assessment, analysis of causes of non-compliance and suggestions for improvement.

A total of 1099 breastmilk donations received by the milk bank at the Amiens University Hospital from January to June 2016 were assessed for bacteriological contamination according to French regulations. This consisted in enumerating the total aerobic flora before and after heat treatment as well as the specific enumeration of coagulase-positive staphylococci. Results above the mandatory limits for at least one of these parameters were found in 25.9% of the donations, resulting in the destruction of approximately one-quarter of the volume of the donations (∼195L). This is a huge loss in both economic and health-related terms for neonates, especially for pre-terms. To identify ways to improve the bacteriological assessment results and reduce the percentage of discarded milk, an analysis of the causes was conducted. The two main causes of non-compliance were the detection of a cultivable aerobic flora after heat treatment and the presence of coagulase-positive staphylococci above the mandatory limit (11.7% and 11.2% of the tested donations, respectively). Bacillus spp. were the leading cause of post-heat-treatment non-compliance. Therefore, the implementation of better environmental control could help reduce this kind of contamination. As for samples harboring coagulase-positive staphylococci, a further detection of toxins using molecular biology techniques could help discriminate actual health-hazardous donations that have to be destroyed while enabling the use of toxin-negative donations. Nevertheless, the economic viability of this proposal needs to be further assessed because these techniques are costly. Finally, a change in breastmilk dilutions used to enumerate the total aerobic flora to better reflect the actual level of these bacteria in the milk was proposed. Indeed, the comparison of various combinations of milk dilutions led to the conclusion that the association of the 1/10 and 1/100 dilutions was the best compromise between technical ease of enumeration and ensuring the safety of the donations. Implementing these suggestions would help reduce the rate of non-compliance and give better access to safe breastmilk donations for neonates.

[Maternal and neonatal factors associated with successful breastfeeding in very preterm infants]. / Facteurs maternels et néonatals associés au succès de l'allaitement maternel à la sortie d'un service de néonatologie chez les grands prématurés.

OBJECTIVE: The main objective of this study was to evaluate the rate of breastfeeding at NICU discharge in a population of very preterm infants. The secondary objective was to identify maternal, gestational, and neonatal factors associated with successful breastfeeding at NICU discharge. MATERIALS AND METHODS: This is a retrospective descriptive study. All live births before 32 weeks of gestational age (WGA) admitted to the NICU of the Amiens university hospital between 1 January 2009 and 30 June 2011 were included in the study, excluding infants who died during hospitalization or infants transferred to another hospital. Data on mothers and newborns were collected from the medical record. Statistical analysis was performed using the Chi(2) test for categorical variables and the Student t test for continuous variables. The significance threshold was set at P<0.05. RESULTS: Seventy-seven infants were included in the study. While 66% of the mothers wished to breastfeed at birth, the success rate of breastfeeding at hospital discharge was only 38%. The proportion of married women was significantly higher in the "successful breastfeeding" group (P=0.029). No significant difference was demonstrated regarding maternal age, maternal profession, proportion of non-smoking mothers, parity, type of pregnancy, type of delivery, duration of invasive ventilation and oxygen dependency, and surgery during hospitalization. CONCLUSION: The rate of breastfeeding of very preterm infants at hospital discharge is lower than the rates reported in the literature. The mother's marital status significantly influences the decision to breastfeed very preterm infants at discharge.

Biomimetic layer-by-layer templates for calcium phosphate biomineralization.

Carboxylated, sulfated and/or phosphorylated surfaces are admitted as potential optimal templates for biomimetic deposition of calcium phosphate (CaP) coatings in view of improving implants' osseointegration. Layer-by-layer films were built up consisting of anionic chondroitin sulfate (ChS), a biological carboxylated and sulfated polysaccharide and cationic poly(l-lysine) (PLL). The films were used as soft matrices to immobilize a model phosphoprotein, phosvitin (PhV). The respective roles of ChS, PLL and PhV terminal layers on the heterogeneous nucleation kinetics and the structure of CaP deposits obtained from supersaturated solutions were inspected. Critical supersaturation ratios and induction times preceding heterogeneous nucleation were precisely determined and interpreted within the framework of classical nucleation theory in order to derive the effective interfacial energies of CaP crystals. It was found that the potency of terminal layers toward CaP nucleation increased in the order: PLL