May 3, 2017
Volume VIII |  Issue No. 18

Transfer of low dose aspirin in human milk
Aspirin which has both antipyretic and anti-inflammatory properties is frequently used during pregnancy and lactation.

A study which evaluated at 0, 1, 2, 4, 8, 12 and 24 hours the transfer of acetyl salicylic acid and its metabolite salicylic acid into breast milk following a single dose of 81mg aspirin indicates that in all samples acetylsalicylic levels are below the limit of measurement while the average concentration of salicylic acid is at sub-clinical levels (estimated relative infant does 0.4%) and should be considered safe.

Analgesic effect of maternal human milk odor on premature neonates
A prospective, randomized, controlled, double blinded and centrally administered study investigated pain in 33 breast fed infants born between 30-36 weeks + 6 days gestational age and less than 10 days postnatal age, exposed to maternal milk odor (via a diffuser or not) who underwent venipuncture. Pain was assessed using the Premature Infant Pain Profile and the length of associated crying. It appears that the odor of mothers' breast milk diminishes significantly pain scores and the duration of crying.

Breast feeding and risk of breast cancer
A systematic review of studies published analyzing breast feeding and breast cancer risk indicates that breast feeding (exclusive or otherwise) among parous women (vs. those women who have never breast fed) reduces the risk for developing breast cancer subsequently in both pre and post-menopausal women.
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Nipple pain, predisposing factors, recovery period and exclusive breast feeding outcome

A study of 1,649 singleton mothers at a follow-up breast feeding clinic identified mothers who experienced nipple pain and evaluated exclusive breast feeding outcomes of mothers who did or did not experience nipple pain at 6 weeks post-partum.
Results indicate:
  1. 9.6% of postpartum mothers experience nipple pain by day 7.
  2. Primiparity is the most relevant predisposing factor.
  3. Reasons for pain include inappropriate positioning, latching problems, tongue tie and oversupply of milk.
  4. Aftercare management results in improvement in in 1-2 weeks.
  5. At 6 weeks with treatment, mothers with and without nipple pain have the same exclusive breast feeding rates.
Maternal supplementation with omega-3 precursors on human milk composition

Increased infant omega-3 levels appear to be associated with improved IQ at 5-6 years of age.

A multicenter factorial randomized trial which examined a 15-day maternal supplementation program with omega-3 polyunsaturated fatty acids - PUFA - (against non PUFA-containing oils) indicates that maternal supplementation of a combination of enriched margarine and rape-seed significantly increases omega-3 levels in human milk.

Video Feature
PUFAsa nd Brain Health
PUFAs and Brain Health
Multi-donor intensive fecal microbiota transplantation (FMT) for active ulcerative colitis

A multicenter, double-blind, randomized, placebo controlled trial of 85 patients (with FMT from 3-7 unrelated donors) with active ulcerative colitis (Mayo Score 4-10; the Mayo Score evaluates increasing severity by increased number
Fecal Transplantation
Video: Fecal Transplantation 
assigned to stool frequency, rectal bleeding, physician assessment and endoscopic findings on a scale of 1-12) had either fecal microbiota transplantation or placebo colonoscopic infusion followed by enemas 5 days/week for 8 weeks. Primary outcome was steroid free clinical and endoscopic remission/significant improvement at week 8.

Intensive dosing, multi-donor fecal microbiota transplantation in active ulcerative colitis induces clinical remission and significant endoscopic improvement.

"DRESS syndrome and medications" 
The Dress syndrome (Drug Reaction with Eosinophilia Systemic Symptoms) is a rare but severe drug hypersensitivity reaction presenting 2-6 weeks after drug exposure with skin eruption (morbilliform) fever,
Video: DRESS Syndrome
Video: DRESS Syndrome
lymphadenopathy, eosinophilia (in 90% of cases) and organ system involvement (liver most frequently). The pathogenesis is unclear.

A case presentation of a 16-year old boy who developed DRESS Syndrome after treatment with amoxicillin for a presumed streptococcal pharyngitis reminds us that other drugs commonly implicated include sulfasalazine, minocycline, aromatic anticonvulsants (e.g. phenytoin, phenobarbital, carbamazepine, primidone) and dapsone. Treatment appears to include discontinuing the offending drug and corticosteroids

Judge Federico A. Moreno Joins Board of Nicklaus Children's Hospital

Judge Federico A. Moreno, United States District Judge for the Southern District of Florida, has been appointed to the board directors of Nicklaus Children's Hospital, flagship of Miami Children's Health System. Judge Moreno joins the 18-member panel, which provides oversight and guidance to the 289-bed freestanding pediatric specialty hospital and its network of 10 outpatient centers extending from southern Miami-Dade County to Palm Beach Gardens.

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