Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol
Introduction Breastfeeding is the biological norm for infant nutrition. In certain scenarios, feeding at the breast is not possible, because of either maternal or neonatal reasons. In those cases, infants can still receive expressed mother’s own milk (MOM) and its beneficial properties. Mothers can...
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BMJ Publishing Group
2025-02-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/2/e087539.full |
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| author | Daniel Klotz Carolyn Smith Agnieszka Bzikowska-Jura Marzia Giribaldi Tanya Cassidy Laura Cavallarin Serena Gandino Karolina Karcz Chiara Peila Bartłomiej Walczak Aleksandra Wesolowska |
| author_facet | Daniel Klotz Carolyn Smith Agnieszka Bzikowska-Jura Marzia Giribaldi Tanya Cassidy Laura Cavallarin Serena Gandino Karolina Karcz Chiara Peila Bartłomiej Walczak Aleksandra Wesolowska |
| author_sort | Daniel Klotz |
| collection | DOAJ |
| description | Introduction Breastfeeding is the biological norm for infant nutrition. In certain scenarios, feeding at the breast is not possible, because of either maternal or neonatal reasons. In those cases, infants can still receive expressed mother’s own milk (MOM) and its beneficial properties. Mothers can express their milk using a variety of methods, while applying different hygiene practices, in different settings; moreover, expressed milk might receive processing before it is fed to the infant, particularly to reduce transmission of viruses such as cytomegalovirus to premature infants. The present protocol was designed to gather the evidence on the effect that the expression method, the hygiene regimen and setting and any processing used on expressed MOM can have on the clinical outcomes of recipient infants.Methods This systematic review will follow the methodological recommendations of the Cochrane Collaboration, in accordance with WHO recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will apply a hybrid search strategy, by combining structured database search with predefined snowballing searches. We will include primary research studies only, without restrictions on the type and including observational studies; no publication time, setting or language restriction will be applied, provided the abstract is available in English. Studies evaluating different methods of MOM expression, hygiene practices or settings during expression, processing of MOM and reporting clinical outcomes on recipient infants will be eligible. The searches have been planned to be performed in April–May 2024. Two reviewers will independently perform the reference screening, data extraction and risk of bias analysis of eligible studies, by using standardised tools specific for each study design. Quantitative and thematic narrative data synthesis will be performed and statistical heterogeneity between studies tested. Meta-analyses of extracted data will be performed where applicable. For relevant outcomes, certainty of the evidence will be tested by using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and dissemination Ethical approval is not required for this study since no original data will be collected. There is patient and public involvement throughout this research process. The results of this review will be disseminated through publication in a peer-reviewed journal and through conference presentations. Moreover, this systematic review will inform recommendations on milk banking of the WHO Department of Nutrition and Food Safety.PROSPERO registration number CRD42024523299. |
| format | Article |
| id | doaj-art-7ced7be1532b49d1b45ef3730930ee8d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-7ced7be1532b49d1b45ef3730930ee8d2025-02-11T19:55:09ZengBMJ Publishing GroupBMJ Open2044-60552025-02-0115210.1136/bmjopen-2024-087539Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocolDaniel Klotz0Carolyn Smith1Agnieszka Bzikowska-Jura2Marzia Giribaldi3Tanya Cassidy4Laura Cavallarin5Serena Gandino6Karolina Karcz7Chiara Peila8Bartłomiej Walczak9Aleksandra Wesolowska10Center for Pediatrics and Adolescent Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyBodleian Health Care Libraries, University of Oxford, Banbury, UKLaboratory of Human Milk and Lactation Research, Department of Medical Biology, Medical University of Warsaw, Warsaw, PolandInstitute of Sciences of Food Productions, National Research Council, Grugliasco, Torino, ItalyKathleen Lonsdale Institute for Human Health Research, Maynooth University, Maynooth, IrelandInstitute of Sciences of Food Productions, National Research Council, Grugliasco, Torino, ItalyNuffield Department of Women`s & Reproductive Health, University of Oxford, John Radcliffe Hospital, Oxford, UK6 Department and Clinic of Neonatology, Wroclaw Medical University, Wroclaw, PolandNeonatal Unit, Department of Public Health and Pediatrics, University of Turin, Torino, ItalyInstitute of Applied Social Sciences, University of Warsaw, Warszawa, PolandLaboratory of Human Milk and Lactation Research, Department of Medical Biology, Medical University of Warsaw, Warsaw, PolandIntroduction Breastfeeding is the biological norm for infant nutrition. In certain scenarios, feeding at the breast is not possible, because of either maternal or neonatal reasons. In those cases, infants can still receive expressed mother’s own milk (MOM) and its beneficial properties. Mothers can express their milk using a variety of methods, while applying different hygiene practices, in different settings; moreover, expressed milk might receive processing before it is fed to the infant, particularly to reduce transmission of viruses such as cytomegalovirus to premature infants. The present protocol was designed to gather the evidence on the effect that the expression method, the hygiene regimen and setting and any processing used on expressed MOM can have on the clinical outcomes of recipient infants.Methods This systematic review will follow the methodological recommendations of the Cochrane Collaboration, in accordance with WHO recommendations and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will apply a hybrid search strategy, by combining structured database search with predefined snowballing searches. We will include primary research studies only, without restrictions on the type and including observational studies; no publication time, setting or language restriction will be applied, provided the abstract is available in English. Studies evaluating different methods of MOM expression, hygiene practices or settings during expression, processing of MOM and reporting clinical outcomes on recipient infants will be eligible. The searches have been planned to be performed in April–May 2024. Two reviewers will independently perform the reference screening, data extraction and risk of bias analysis of eligible studies, by using standardised tools specific for each study design. Quantitative and thematic narrative data synthesis will be performed and statistical heterogeneity between studies tested. Meta-analyses of extracted data will be performed where applicable. For relevant outcomes, certainty of the evidence will be tested by using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and dissemination Ethical approval is not required for this study since no original data will be collected. There is patient and public involvement throughout this research process. The results of this review will be disseminated through publication in a peer-reviewed journal and through conference presentations. Moreover, this systematic review will inform recommendations on milk banking of the WHO Department of Nutrition and Food Safety.PROSPERO registration number CRD42024523299.https://bmjopen.bmj.com/content/15/2/e087539.full |
| spellingShingle | Daniel Klotz Carolyn Smith Agnieszka Bzikowska-Jura Marzia Giribaldi Tanya Cassidy Laura Cavallarin Serena Gandino Karolina Karcz Chiara Peila Bartłomiej Walczak Aleksandra Wesolowska Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol BMJ Open |
| title | Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol |
| title_full | Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol |
| title_fullStr | Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol |
| title_full_unstemmed | Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol |
| title_short | Impact of mother’s own milk expression practices and processing treatments on infant health and growth outcomes: a systematic review protocol |
| title_sort | impact of mother s own milk expression practices and processing treatments on infant health and growth outcomes a systematic review protocol |
| url | https://bmjopen.bmj.com/content/15/2/e087539.full |
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