Giving our tiniest patients a boost

Dr. Deborah O'Connor and Dr. Sharon Unger

A team of Toronto researchers is focused on improving health outcomes for the most vulnerable of patients – preterm infants.

Dr. Deborah O'Connor and Dr. Sharon Unger are leaders in advancing the care of preterm infants, with a special focus on the nutrition of very low birthweight infants.

Making human milk available to preterm babies

A full-term human pregnancy lasts almost 40 weeks. Preterm infants or "preemies" are born before 37 weeks with some babies as early as 22 weeks now surviving.

Because their tiny organs and immune systems are still developing, preterm infants are extremely fragile and run a very high risk of developing life-threatening complications, including brain injury, infections, respiratory problems, and an intestinal condition called necrotizing enterocolitis.

Mother's own milk with added nutrients to meet their elevated nutritional requirements provides the ideal source of nutrition for these tiny humans. It's easily digestible and contains nutrients and bio-active compounds that promote optimal growth and development of the gastro-intestinal, neurological and immunological systems that allow them to enjoy a high survival rate. It also helps reduce the risk of complications related to preterm birth.

In the past, when a mother couldn't produce breastmilk or couldn't produce a sufficient quantity, supplementation with cow's milk based infant formula was the only alternative.

Now human milk banks give these families another option —pasteurized donor human milk.

Dr. Unger is the medical director and Dr O'Connor chairs the advisory committee for the Rogers Hixon Ontario Human Milk Bank, a provincial initiative located at Mount Sinai Hospital. The bank provides neonatal intensive care units across Ontario with a secure source of donor milk, rich in health promoting bio-active compounds.

Maximizing mother's milk for very low weight babies

Dr. O'Connor and Dr. Unger are carrying out research using the resources of the Rogers Hixon Ontario Human Milk Bank and its collaborating neonatal intensive care units.

Their research has included studies comparing the effect of supplementing mother's milk with human donor milk versus formula on the growth and neurodevelopment of very low weight babies. They have studied the impact of different types of feeding on the gut health of very low weight babies. They are also examining how to boost mother's milk and donor milk with the addition of extra nutrients.

This work is helping develop nutritional guidelines for preterm infants. At the same time, Dr. O'Connor and Dr. Unger are guiding the development of national protocols for the handing, processing and storage of donor human milk.

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