Cellular Components of Human Milk: An Examination of Their Role in Infant Health and Development and the Functional Impact of Hospital Storage Practices

Project Summary/Abstract
Preterm infants are at increased risk of health complications due to their under-developed organ systems at
birth, and human milk receipt is recognized as an important intervention to promote infant health. Recent
identification of cells in human milk which have similar characteristics to stem cells, as well as animal models
which show integration of these cells into nursling's organs, indicate an important function of milk cells which is
currently not understood. In the NICU, infants often receive human milk which has been refrigerated or frozen,
and then warmed and/or thawed prior to feeding. The impact of these typical handling practices on the cellular
components of milk that may provide an important mechanism of biologic protection in infant health has not
been investigated. This work will determine how the real-life storage and handling of human milk impacts infant
health and development, and is the first to evaluate protective mechanisms. There are currently two major
knowledge gaps in the fields of human milk and lactation and neonatal care surrounding bioactive cellular
components. The first is a lack of knowledge of how real-life storage and handling practices impact the
protective ability of milk's cellular components for infants. Without this knowledge, infants who may benefit from
milk with the most bioactivity (such as preterm infants) may not receive the properties of their mother's milk
which provide important protection. The second major opportunity is the lack of knowledge on the
mechanism(s) of protection in milk stem-like cells. Additionally, as research techniques advance our ability to
investigate milk components, there is a great need to look at milk components in a biological systems
perspective. The specific aims of the research project are to 1) examine how hospital storage practices
(refrigeration and freezing) impact the protective mechanisms of human milk cells through the use of a tissue
culture model of intestinal health, and 2) determine if milk cells are integrated as functioning cells specific to
vital organs impacted by preterm birth (brain, heart, lungs, intestine) using a cross-foster mouse model. Upon
completion of the specific aims of the K23 research strategy and training plans, the candidate will have
advanced theoretical knowledge and technical skills to conduct human milk research with the ability to apply a
biological systems approach to understand the complexity of the many components of milk which likely impact
the function of each. The proposal research aims are supported by research training, didactic coursework,
scientific meetings, and specific plans for dissemination and future growth. Ultimately, the short- and long-term
goals of this research are to 1) improve infant health by optimizing the delivery of the most bioactive human
milk components and 2) determine the mechanism(s) by which human milk cells protect infants and promotes
growth and development.

Grant Number: 5K23HD102580-05
NIH Institute/Center: NIH
Principal Investigator: Carrie-Ellen Briere