Human Milk Feeding as a Protective Factor for Retinopathy of Prematurity: A Meta-analysis

Zhou, Jianguo; Shukla, Vivek V.; John, Denny; Chen, Chao

doi:10.1542/peds.2015-2372

Cited by 92 publications

(67 citation statements)

References 38 publications

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“…Breastmilk feeding has been associated with less necrotising enterocolitis and ROP,55 but there are no RCT data whether it prevents BPD. Data from the German Neonatal Network, however, showed that exclusively formula-fed infants had 2.6-times the risk of developing BPD in multivariate analysis than exclusively breastmilk-fed infants 56.…”

Section: Introductionmentioning

confidence: 99%

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Poets

Lorenz

2018

Arch Dis Child Fetal Neonatal Ed

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Bronchopulmonary dysplasia (BPD) is one of the most frequent complications in extremely low gestational age neonates, but has remained largely unchanged in rate. We reviewed data on BPD prevention focusing on recent meta-analyses. Interventions with proven effectiveness in reducing BPD include the primary use of non-invasive respiratory support, the application of surfactant without endotracheal ventilation and the use of volume-targeted ventilation in infants requiring endotracheal intubation. Following extubation, synchronised nasal ventilation is more effective than continuous positive airway pressure in reducing BPD. Pharmacologically, commencing caffeine citrate on postnatal day 1 or 2 seems more effective than a later start. Applying intramuscular vitamin A for the first 4 weeks reduces BPD, but is expensive and painful and thus not widely used. Low-dose hydrocortisone for the first 10 days prevents BPD, but was associated with almost twice as many cases of late-onset sepsis in infants born at 24-25 weeks' gestation. Inhaled corticosteroids, despite reducing BPD, were associated with a higher mortality rate. Administering dexamethasone to infants still requiring mechanical ventilation around postnatal weeks 2-3 may represent the best trade-off between restricting steroids to infants at risk of BPD while still affording high efficacy. Finally, identifying infants colonised with ureaplasma and treating those requiring intubation and mechanical ventilation with azithromycin is another promising approach to BPD prevention. Further interventions yet only backed by cohort studies include exclusive breastmilk feeding and a better prevention of nosocomial infections.

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Section: Introductionmentioning

confidence: 99%

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Poets

Lorenz

2018

Arch Dis Child Fetal Neonatal Ed

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“…Breast milk contains nutrients and immune factors which promote growth and overall long‐term health Breastfed infants are less susceptible to inflammatory disorders, infection and may have reduced incidence of cardiovascular disease in adult life . Benefits specific to preterm infants include the promotion of intestinal maturation, improved feed tolerance, improved growth and reduced severity of complications of prematurity such as necrotising enterocolitis …”

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confidence: 99%

What evidence‐based strategies have been shown to improve breastfeeding rates in preterm infants?

Hilditch

Howes

Dempster

et al. 2019

J Paediatrics Child Health

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Breast milk is the preferred form of nutrition for all infants and has been shown to reduce morbidity and improve health outcomes in preterm infants. However, mothers of preterm infants face many challenges initiating and sustaining breastfeeding within the neonatal unit. This scoping review examines evidence-based practices which aim to improve breastfeeding rates in preterm infants at the time of hospital discharge. A literature review identified 17 articles which are included in this review. Supporting evidence was found for the implementation of kangaroo mother care and/or skin-to-skin care, peer counsellors, provision of oropharyngeal colostrum in early infancy and use of donor human milk banks. However, overall it is apparent that high quality research including systematic review and data synthesis in the form of meta-analysis is required in this area to reach sound conclusions regarding recommendations of different interventions. This scoping review provides an important foundation for further research into this area.Key words: breastfeeding or breast milk or growth; clinical improvement or quality improvement or gold standard or guideline; intensive care units, neonatal; nutritional outcome.Human breast milk is the recommended source of nutrition for all infants. 1 Breast milk contains nutrients and immune factors which promote growth and overall long-term health 2,3 Breastfed infants are less susceptible to inflammatory disorders, infection and may have reduced incidence of cardiovascular disease in adult life. 4-7 Benefits specific to preterm infants 8 include the promotion of intestinal maturation, improved feed tolerance, improved growth 7 and reduced severity of complications of prematurity such as necrotising enterocolitis. [9][10][11] Despite the overwhelming evidence that breast milk is beneficial for preterm infants, breastfeeding rates within Australian neonatal units remain low. 7 The neonatal unit environment presents unique challenges to breastfeeding, with mothers often having to establish and maintain a breast milk supply without the direct assistance of their babies. Other barriers to breastfeeding success include limited support from health-care professionals, perceived lack of breast milk supply, lack of privacy for expressing milk, and the stress of having a preterm infant in neonatal intensive care and inadequate information regarding the benefits of breast milk. 12,13 Multiple evidence-based interventions to improve breastfeeding rates have been explored.In this narrative review, we considered the structured clinical question 'In a preterm infant (born <37 weeks' gestation) admitted to a neonatal unit, what evidence-based practices, compared to standard care, have been shown to improve the use of breast milk and breastfeeding rates upon discharge and up to 6 months of age?' DefinitionsBreastfeeding was defined as any administration of breast milk by any method (tube, breast, alternative, such as bottle or syringe). Search Strategy and OutcomeMedline, Embase, Maternity and Infant Care,...

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“…Several reviews summarise the findings in this field. A 2015 meta-analysis reports that, for exclusive human milk versus exclusive formula, the ORs (95% CIs) for anystage ROP and for severe ROP, are 0.25 (0.13-0.49) and 0.10 (0.04-0.29), respectively (2).…”

mentioning

confidence: 99%

Potential contribution of feeding type to WINROP

2019

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Human Milk Feeding as a Protective Factor for Retinopathy of Prematurity: A Meta-analysis

Cited by 92 publications

References 38 publications

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

What evidence‐based strategies have been shown to improve breastfeeding rates in preterm infants?

Potential contribution of feeding type to WINROP

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