Effects of Non-Maternal Breastfeeding on Clinical and Hematological Outcomes in Infants with Beta-Thalassemia Major: A Randomized Interventional Study in Iraq

Subject Areas :

Mohammad Jamil Al-Habbal ¹ , Nabeel Najib Fadhil ² , Madyan Mohammed Fawzi Al-Ghrer ³ , Mekdad Al Juwary ⁴ , Mohammed Chyad Al-Noaemi ^{5 *} , Yusra Ahmed AL-Hially ⁶

1 - Prof. of internal medicine, Consultant in internal medicine and nephrology
2 - Prof. of internal medicine, Consultant in endocrinology and diabetes.
3 - Specialist pediatrician, Director of Alhadbaa Blood and Bone Marrow Transplant Hospital. Director of Mosul Thalassemia Center
4 - Prof. of Biomedical Sciences, Director of hStem Cells Therapy for BMT, Policlinic, To Vergata University Hospital, Rome, Italy
5 - Department of Medical Physiology, College of Medicine, Al-Ayen Iraqi University, AUIQ, An Nasiriyah, Iraq
6 - College of Medicine, Ninevah University. Treating physician at Thalassemia Center, Mosul, Iraq

Received: 2024-10-08 Accepted : 2025-02-08 Published : 2025-08-09

Keywords: Thalassemia, non-mother, breast-feeding, stem cells, microRNA, therapy.,

Abstract :

Thalassemia major is a severe disease that can be fatal if untreated or improperly treated. There are four therapy options: blood transfusion, iron chelation therapy, gene therapy, and bone marrow transplantation. To reduce the severity of thalassemia major in affected infants, it is recommended that they breastfeed using milk from healthy, non-maternal nurses, utilizing the stem cells and microRNA functions of breast milk. This study investigates the effects of non-maternal breastfeeding (NMBF) on clinical and hematological outcomes in infants diagnosed with beta-thalassemia major. The research was conducted at the Thalassemia Center in Nineveh Governorate, Iraq, and involved a randomized interventional design with ethical approval from the local health authority. The study highlights the potential benefits of introducing breast milk from healthy, unrelated nurses to thalassemic infants. The findings indicate that after six months of NMBF, there were significant improvements in both hematologic and clinical outcomes, including reduced splenomegaly and a decreased frequency of blood transfusions compared to the control group. The underlying mechanisms may involve the roles of microRNAs (miRNAs) and stem cells present in breast milk, which could enhance erythropoiesis and immune function. Despite the promising results, the study acknowledges limitations such as difficulty locating wet nurses and some families' noncompliance with follow-ups. This research suggests that NMBF could be a safe, cost-effective, and easily administered therapeutic option for managing beta-thalassemia major in infants. Further multicenter studies with long-term follow-ups are recommended to validate these findings and explore the specific mechanisms of action involved in this innovative treatment approach.

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