Mother's Own Milk and Its Relationship to Growth and Morbidity in a Population‐based Cohort of Extremely Preterm Infants

Abstract

Objectives: The aim of the study was to evaluate the relationships between intake of mother's own milk (MOM), compared with intake of pasteurized donor milk (DM), and postnatal growth, incidence of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD), in extremely preterm infants. Methods: Swedish population-based cohort of surviving extremely preterm infants born 2004 to 2007. Exposure to MOM and DM was investigated from birth until 32 weeks postmenstrual age (PMA) in 453 infants. Primary outcome variables were change in z -score (Δ) from birth to 32 weeks PMA for weight, length, and head circumference (HC). Secondary outcomes were incidence of ROP and BPD. Mixed models adjusting for confounders were used to investigate the association between exposures and outcomes. Results: Infants’ mean gestational age (GA) was 25.4 weeks. Unadjusted, MOM (per 10 mL · kg −1 · day −1 ) was associated with Δweight and ΔHC with beta estimates of 0.03 z -score units (95% CI, 0.02–0.04, P < 0.001) and 0.03 z -score units (95% CI, 0.01–0.05, P = 0.003), respectively. After adjustment for predefined confounders, the association remained significant for Δweight and ΔHC. A similar pattern was found between Δweight and each 10% increase of MOM. Unadjusted, a higher intake of MOM (mL · kg −1 · day −1 ) was significantly associated to a lower probability of any ROP and severe ROP; however, these associations did not remain in the adjusted analyses. No associations were found between MOM (mL · kg −1 · day −1 ) and BPD. Moreover, no associations were found between DM and growth or morbidity outcomes. Conclusions: An increased intake of MOM, as opposed to DM (and not formula feeding), was associated with improved postnatal weight gain and HC growth from birth until 32 weeks PMA in extremely preterm infants. Interventions aiming at increasing early intake of unpasteurized MOM for extremely preterm infants should be encouraged.

A Digital Twin of the Infant Microbiome to Predict Neurodevelopmental Deficits

“…For example, in our test case of preterm infant HCG in the NICU, results from the Q-net suggest that a microbial-based intervention of Bacteroidia and/or Verrucomicrobiae at 28-29 weeks PMA would be most effective, with subsequent maintenance by human milk feeding. We note here that human milk feeding is primarily with mom's own milk; different effects on microbiome maturation trajectories may be observed with donor milk, as infant HCG outcomes are reported to be divergent between these two feeding types 45 . The UChicago cohort lacked sufficient number of participants to test how the mother's own vs donor milk altered microbiome maturation (we had only two samples where donor milk was used), which would be investigated in future work.…”

JPGN and the Year 2022

“…This paper in a large national population‐based cohort of extremely preterm infants evaluated the effects of unpasteurized mother’s own milk (MOM) and pasteurized donor milk (DM) on postnatal growth and morbidities (7). Unadjusted, MOM (per 10 mL/kg/day) was associated with Δweight and Δhead circumference (HC) and these remained significant after adjustment for predefined confounders.…”