Short‐term effects of fresh mother's own milk in very preterm infants

Abstract

Fresh mother's own milk (MOM) can protect preterm infants from many complications. Often MOM is pasteurized for safety, which can deactivate cellular and bioactive components with protective benefits. Questions remain regarding whether pasteurized MOM provides the same benefits as fresh MOM. The aim of this study was to evaluate the association and feasibility of feeding very preterm infants with fresh MOM. This prospective cohort study included 157 very preterm infants born before 32 weeks' gestational age and with a birthweight below 1500 g. Of these, 82 infants were included in the fresh MOM without any processing group and 75 infants were included in the pasteurized never-frozen MOM (PNFMOM) group. The mortality rate, survival rate without severe complication, incidence of complications, feeding indexes and growth velocities were compared to assess the association and feasibility of feeding fresh MOM. Compared with the PNFMOM group, the fresh MOM group had a higher survival rate without severe complications (p = 0.014) and a lower incidence of bronchopulmonary dysplasia (p = 0.010) after adjustment for confounders. The fresh MOM group regained birthweight earlier (p = 0.021), reached total enteral feeding earlier (p = 0.024), and received total parenteral nutrition for less time (p = 0.045). No adverse events associated with fresh MOM feeding were recorded. Feeding fresh MOM may reduce the incidence of complications in very premature infants. Fresh MOM was shown to be a feasible feeding strategy to improve preterm infants' outcomes.breastfeeding, infant, premature, prognosis, very preterm infant 1 | BACKGROUND Breast milk is recognized as the ideal feeding type for all infants due to its known nutritional components (e.g., proteins, carbohydrates, vitamins and minerals) and bioactive components (e.g., live immune cells, lactoferrin, secretory immunoglobulin A, cytokines, hormones and growth factors) that possess immune and antimicrobial activities (Ballard & Morrow, 2013;Mosca & Giannì, 2017). Multiple studies have suggested that breastfeeding in the neonatal intensive care unit (NICU) can improve infants' feeding tolerance (Assad et al., 2016); decrease the incidence of

Breast-feeding as protective factor against bronchopulmonary dysplasia in preterm infants

“…Our study shows that feeding with MOM in the first 2 weeks of life significantly reduces the risk of BPD, which is in line with the findings of Huang et al (54) and Patel et al (55) , who reported a 9·5 % reduction in the probability of BPD for each 10 % increase in the volume of breast milk consumed. Another meta-analysis and retrospective study also found that breast-feeding was associated with a lower risk of BPD (56) .…”

Study on improving collection feeding safety and quality of colostrum for very (extremely) low birth weight infants

“…Adverse events related to colostrum feeding, including intestinal infection caused by colostrum contamination ( 21 , 22 ), feeding errors, or omissions, were collected and recorded by NICU nurses. Nosocomial intestinal infections could be due to bacterial infection in the gastrointestinal tract after ingesting contaminated colostrum due to improper colostrum collection or transportation or improper disinfection of breast pump accessories and collection cups.…”

A Systemic Review of the Difference Between Diets for Preterm Infants Containing Raw Mother’s Own Milk and Frozen or Pasteurized Mother’s Own Milk

“…A decrease in common reasons for preterm infant morbidity was found in three studies (Dicky et al, 2017;Huang et al, 2023;Sun et al, 2019). A significant decrease in BPD (OR = 0.40, 95% CI [0.27, 0.67], p < 0.001) was found by Dickey et al ( 2017), who compared NICUs with a feeding policy that supported the use of rMOM versus those with policies requiring pasteurization of MOM for infants < 1500 g. In a prospective cohort study (N = 157), Huang et al (2023) also found an improvement in BPD for preterm infants fed rMOM (OR = 0.345, 95% CI [0.15, 0.77], p = 0.010).…”

“…One study was appraised as moderate owing to the risk of sampling bias (de Oliveira et al, 2017). The remaining six studies were appraised as strong (Cossey et al, 2013(Cossey et al, , 2014de Halleux et al, 2019;Dicky et al, 2017;Huang et al, 2023;Sun et al, 2019). A summary of included study variables, measurement processes, key findings, and quality is provided in Table 2.…”

“…rMOM = raw mother's own milk human milk expressed, kept at room temperature, and fed within 4 hr (Sun et al, 2019); pMOM = pasteurized mother's own milk that has been heat-treated for 30 min at 62.5 °C (Holder method) and then refrozen until needed (Picaud et al, 2018); fMOM = frozen mother's own milk is expressed MOM that has been kept at temperatures at or below -18 °C ± 2 °C (Picaud et al, 2018); GA = gestational age measured in weeks; BW = birth weight; RCT = randomized controlled trial; DHM = donor human milk. (Cossey et al, 2013;de Halleux et al, 2019;Huang et al, 2023;Sun et al, 2019). No fortifiers were used in one of the studies that reported growth-related outcomes (Andersson et al, 2007).…”