TMC PULSE

t m c » p u l s e | m a y 2 0 1 6 30 Liquid Gold How donated breast milk helps Texas Children's Hospital improve outcomes for its tiniest patients B y A l e x a n d r a B e c k e r T he quest to replicate biological matter is one of modern medicine's most promising endeavors, but also one of its greatest challenges. Be it synthetic blood, xenotransplantation efforts or extracellular matrix tech- nology, the field has the potential to transform health care and save count- less lives. The problem is, nature is just smarter than we are—at least for now. Nowhere is this truer than in the case of infant formula. No matter how comprehensive the list of essential vitamins, minerals, proteins, fats and carbohydrates, even the best brands on the market can't touch the composition of breast milk. That's because breast milk is tailor-made to produce the nutri- ents a baby needs to grow and develop, including living antibodies for fighting infection as well as healthy bacteria which supports early development of the microbiome. Again and again, studies have indicated that because of these factors, breast milk is beneficial for neurological development and general growth and is associated with a decreased risk of ear and respiratory infections, GI issues, asthma, eczema, SIDS, juvenile-onset diabetes, child- hood obesity, allergies—the list goes on. Its unique biological properties are especially important for premature infants whose digestive systems are underdeveloped and often have trouble tolerating formula. One of the most common and fatal conditions observed in low birth weight preemies—those weighing 1500 grams (3.3 lbs.) or less—is an illness called necrotizing enterocolitis (NEC), in which the immature intestinal lining decays as a result of infection and inflammation. Research has shown that babies who receive breast milk are at a much lower risk of developing NEC, suggesting that the cow's milk proteins found in formula may contribute to the infection itself. "After implementing an all-human milk diet in our NICU, we watched our intestinal infection rate of necro- tizing enterocolitis fall from 14 percent to somewhere between two and three percent," said Amy Hair, M.D., neona- tologist and director of the neonatal nutrition program at Texas Children's Hospital. Their all-human milk protocol was initiated in 2009 in response to the overwhelming evidence emerging at the time that exclusive breast-feeding, put simply, saved lives. "Breast milk is special," said Hair. "It's specifically designed for human baby bodies." Hair explained that the composition of a mother's milk changes over time to meet the growing needs of her baby. The first type of milk a mother pro- duces, called colostrum, is high in fat and protein and contains concentrated immune factors, and, like all breast milk, is easily absorbed in the intestine—it's exactly what a doctor would prescribe for newborns, espe- cially preemies who sometimes have weeks, if not months, of gestational development left to complete. "We were noticing over the years, since we began this in 2009, that our babies were just doing better," Hair said. "Our overall outcomes were better. So we looked at data from before we implemented this protocol to after, and what we found was that babies who received all human milk have less complications of prematurity. They had less severe retinopathy of prematurity, which leads to blindness, less chronic lung disease, less infec- tions and less mortality." The properties are so potent that even a few drops contribute to an overall improvement in health. Hair cited a few recent studies that showed even tiny premature babies who cannot be orally fed or fed with a feeding tube benefited from caregivers taking just a small amount of the mother's colostrum and swabbing their mouths with it. "It was shown to decrease infection and start building their immune system and microbiome," she said. Amy Hair, M.D., neonatologist and director of the Neonatal Nutrition Program at Texas Children's Hospital, pictured inside the milk bank. SINCE TEXAS CHILDREN'S HOSPITAL LAUNCHED THE DONOR MILK BANK PROGRAM IN 2011, THE HOSPITAL HAS COLLECTED OVER 227,000 OUNCES FROM MOTHERS IN THE COMMUNITY.

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