The microbiome innovation has resulted in an umbrella term, postbiotics, which refers to non-viable microbial cells, metabolic byproducts and their microbial components released after lysis. Postbiotics, modulate immune response, gene expression, inhibit pathogen binding, maintain intestinal barriers, help in controlling carcinogenesis and pathogen infections. Postbiotics have antimicrobial, antioxidant, and immunomodulatory properties with favorable physiological, immunological, neuro-hormonal, regulatory and metabolic reactions. Consumption of postbiotics relieves symptoms of various diseases and viral infections such as SARS-CoV-2. Postbiotics can act as alternatives for pre-probiotic specially in immunosuppressed patients, children and premature neonates. Postbiotics are used to preserve and enhance nutritional properties of food, elimination of biofilms and skin conditioning in cosmetics. Postbiotics have numerous advantages over live bacteria with no risk of bacterial translocation from the gut to blood, acquisition of antibiotic resistance genes. The process of extraction, standardization, transport, and storage of postbiotic is more natural. Bioengineering techniques such as fermentation technology, high pressure etc., may be used for the synthesis of different postbiotics. Safety assessment and quality assurance of postbiotic is important as they may induce stomach discomfort, sepsis and/or toxic shock. Postbiotics are still in their infancy compared to pre- and pro- biotics but future research in this field may contribute to improved physiological functions and host health. The current review comprehensively summarizes new frontiers of research in postbiotics.

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As part of integrated newborn care, human milk banks can reduce death and illness as well as lower health-care costs for infants born prematurely, especially with birthweights less than 1,500 g, and for infants born in resource-limited settings without access to their mother’s milk. Promotion of human milk banks is of special significance in India which has the highest burden of such infants. About 50 milk banks are insufficient to meet the needs of vulnerable infants. The government of India has acknowledged the role that human milk banking can play in reducing neonatal mortality and morbidity, and launched the “National Guidelines on Lactation Management Centers in Public Health Facilities” in 2017 with a vision to make breast milk universally available for all infants. The government is now working on an implementation strategy to scale up the lactation management center model (promotion of breastfeeding, kangaroo mother care, and donor human milk) for all newborn care units and delivery centers in the country. However, for effective expansion, it will be important to ensure improved government ownership, mandate availability of standard operating procedures at all facilities, stringent systems of quality control, standardized accreditation, and a robust monitoring system. Local evidence on the effectiveness of the comprehensive lactation management center (CLMC) model and knowledge, practices, and perceptions of human milk banking are limited. There is a need for rigorous implementation, process research, and technology innovation, along with a robust regulatory framework to prevent commercialization. In addition, attitude changes of mothers, maternal influencers, and health-care providers are all essential to successfully expand the CLMC model.

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