Maternal milk feedings reduce sepsis, necrotizing enterocolitis and improve outcomes of premature infants

Objective:human milk (donor milk (dm) and/or maternal milk (mm)) feedings protect against late onset sepsis (los), necrotizing enterocolitis (nec) and death. however, dm lacks many anti-infective components of mm. therefore, we studied exclusive mm feedings to evaluate the full effect of human milk on infectious and other outcomes in premature infants.study design:all infants born before 33 weeks postmenstrual age (pma) who received exclusive (>95%) mm or exclusive preterm formula (pf) were included in this prospective investigation.results:sixty-three infants (53%) received mm and 55 infants (47%) received pf. both groups had similar baseline characteristics. infants in the mm group achieved full enteral nutrition sooner (14±8 vs 19±15 days, p<0.03) and required a shorter duration of central venous lines (14±10 vs 22±21, p<0.005). fewer infants in the mm group developed los (9 vs 19, p<0.05) and pneumonia (8 vs 16, p<0.05) than pf infants. only one mm and five pf infants developed nec (bell stage ⩾ii). logistic regression analysis using pma and prolonged rupture of membranes as covariates demonstrated an increased rate of nec (odds ratio=8.85, ci=1.01 to 25.17, p=0.048) in pf infants. periventricular leukomalacia (pvl) was more common in pf (4 vs 0, p=0.04) than in mm infants.conclusion:feedings of mm advanced more rapidly and were associated with fewer infections than pf. a possible protective effect of mm against pvl, not previously described, may be related to its immune and anti-inflammatory components.