May 17, 2020

KKH and Temasek Foundation Cares launch new milk bank in Singapore

Public Hospital
healthcare services
milk bank
healthcare services
Catherine Sturman
3 min
An average of about 350 very low birth weight infants receive neonatal intensive care in Singapore’s public hospitals each year. KK Women’s and Chil...

An average of about 350 very low birth weight infants receive neonatal intensive care in Singapore’s public hospitals each year. KK Women’s and Children’s Hospital (KKH) and Temasek Foundation Cares have now consequently launched a new S$1.37 million, three-year pilot for Singapore’s first donor human milk bank programme to support this growing need.

Founded back in 1858, KKH is an exceptional teaching hospital for Singapore’s medical school, and has become a leader in obstetrics, gynaecology, paediatrics and neonatology, delivering patient centred management of high risk conditions in women and children.

In KKH, up to 80% of sick neonates in the Neonatal Intensive Care Unit (NICU) and Special Care Nursery (SCN) have to receive formula milk meant for premature babies, either exclusively or partially, during their hospital stay, due to inadequate supply of breast milk.

Funded by Temasek Foundation Cares, and managed by KKH, the milk bank will therefore collect, screen, process and store breast milk received from donors in the region. The bank will follow strict international guidelines for donor screening, recruitment and education, laboratory testing, processing and storage of the pasteurised milk, before it is dispensed for use.

The programme will provide a ready supply of safe, pasteurised human breast milk, donated for premature and sick neonates of mothers who may be unable to provide adequate breast milk to support their babies’ requirement. Over 20 women have already expressed an interest to support the programme.

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It is hoped that the partnership will benefit 900 babies and enable the recruitment of around 375 mothers who are willing to donate their excess supply of breast milk, which will benefit vulnerable premature and sick babies receiving neonatal care in KKH, Singapore General Hospital (SGH) and National University Hospital (NUH) over this three-year period.

Mr Richard Magnus, Chairman, Temasek Foundation Cares, said, “The Temasek Foundation Cares Donor Human Milk Bank programme provides preterm neonates such access who would otherwise be deprived. This programme forms part of a larger initiative to support the health and social development needs of vulnerable children.”

The venture aligns Singapore with 40 other countries worldwide who have launched official milk banks, which is provided free of charge. All donated milk will also be tracked to ensure donors can be traced if necessary.

Dr Chua Mei Chien, Director, Temasek Foundation Cares Donor Human Milk Bank Programme, and Head and Senior Consultant, Department of Neonatology, KKH, said, “Breast milk is the nutritional standard for infants in the first six months of life, and it contains white blood cells and antibodies that protect the baby against infections and improve their chances of survival. The fat globules in breast milk enable better brain development as well as development of vision.

Some mothers, due to preterm or complicated deliveries, or other pre-existing conditions, are unable to meet the breast milk requirement for their babies. Providing safe, pasteurised breast milk from donors to these vulnerable babies allows them to benefit from this ideal source of nutrition while also significantly improving their chances of development and recovery.”

During the pilot period, the Temasek Foundation Cares Donor Human Milk Bank Programme will adopt international guidelines and protocols by the United Kingdom National Institute of Health and Care and Human Milk Banking Association of North America. These guidelines are the most comprehensive, well recognised and widely practiced by established donor milk banks in leading developed countries.

Donors will be required to undergo a stringent donor screening process as well as education on the handling and storage of the breast milk prior to donation.

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Jun 14, 2021

Long haul Covid, the brain and digital therapies

#longcovid
#digitaltherapy
#neuroplasticity
#covid19
4 min
Neuroplasticity expert Ashok Gupta tells us about the symptoms of long Covid, how it affects the brain, and digital therapies

It is estimated that around 10% of people who get Covid-19 develop long haul Covid, a debilitating condition that can last many months and cause breathlessness, exhaustion and pain. 

Research is underway to find out who is more likely to get it and how to treat it. Here neuroplasticity expert and owner of Harley Street Solutions in London Ashok Gupta tells us how the condition affects the brain. 

What is long Covid exactly? 

Long Covid is when patients who have experienced Covid-19 go on to have continuing symptoms for weeks and months afterwards. These symptoms can include breathlessness, exhaustion, brain fog, gastric issues, pain, and post-exertional malaise. It is estimated that around 10% of Covid-19 infections may result in developing long haul symptoms, and in the USA, this may be affecting over 3 million people.

How does it affect the brain?
Here at our clinic, we hypothesise that it is due to a malfunction in the unconscious brain, creating a conditioned response that keeps the body in a hyper-aroused state of defensiveness. At the core of this hypothesis is the idea that we are here because our nervous system and immune system have evolved to survive. We are survival machines!

When we encounter something such as Covid-19, the brain perceives it as life threatening, and rightly so. And in the era of the pandemic, with more stress, anxiety and social isolation, our immunity may be compromised, and therefore it may take longer for the immune system to fight off the virus and recover. 

If the brain makes the decision that this is potentially life threatening and we get to the stage where we’re overcoming the virus, a legacy is left in the brain; it keeps over-responding to anything that reminds us of the virus. Even if we’ve fought off the virus, the brain will react in a precautionary way to stimuli reminiscent of the virus. 

The brain may get stuck in that overprotective response, and keeps stimulating our nervous system and our immune system, just in case the virus may still be present.

What symptoms does this cause? 

These signals cause a cascade of symptoms including breathlessness, extreme fatigue, brain fog, loss of taste or smell, headaches, and many others. And these are caused by our own immunes system.

In the case of long-haul Covid, symptoms in the body get detected by a hypersensitive brain which thinks we’re still in danger. The brain then chronically stimulates the immune and nervous systems, and then we have a continuation of a chronic set of symptoms.

This isn’t unique to long-haul Covid. Many patients develop chronic fatigue syndrome, sometimes known as “ME”, for example, after the flu, a stomach bug, or respiratory illness. Covid-19 may be a severe trigger of a form of chronic fatigue syndrome or ME.

How does long-haul Covid affect mental health? 
Anxiety is a very common symptom in long haulers. It can be frightening to wonder about what may be happening in your body, and what the prognosis is going to be for one’s long term health. Reaching out for support for mental health is crucial for long-haulers.

How does neuroplasticity treatment work for long-haul COVID patients?
We have been working with patients for two decades with a brain retraining programme using neuroplasticity or “limbic retraining.” 

We believe that through neural rewiring, the brain can be “persuaded” that we are no longer in danger and to come back to homeostasis. But to be very clear, we are not saying it is psychological in any way, but we believe there are novel ways of accessing the unconscious brain. 

We recently worked successfully with a 56-year-old male with long-haul Covid, who prior to contracting Covid-19 in March of 2020 was running half-marathons and cycling, but afterwards he struggled to get off the sofa for months. Within 3 months he’s now back to 100% and  running half marathons again.

At our clinic, we train the patient to be able to recognise those subtle unconscious danger signals on the periphery of consciousness. This, coupled with supportive techniques and the natural hallmarks of good health such as sleep and diet help prepare the patient to respond to perceived threats that might trigger the response. 

The natural state of our brain is to default to protection. The brain prioritises survival and passing on our genes to the next generation, over any other impulse. It cares more about that than you feeling healthy and well. Protective responses are evolutionary, and are the right thing for the brain to do – it’s survival. 

What digital therapies or apps are proving effective at treating long-haul Covid? 
It seems that long haul patients are availing themselves of many online therapies and services, including meditation apps and wellness websites. We have an online neuroplasticity “brain retraining” video course called the “Gupta Program” which hosts 15 interactive videos and many audio exercises. This is proving very popular with long haul patients, and we are currently conducting a trial to test the effectiveness of this therapy. 

What is the danger of leaving long-haul Covid untreated?
The longer it goes untreated, we hypothesise that it may become more entrenched in the brain, and  become chronic in the longer term. Therefore we advise all patients to get help and advice as soon as possible.

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