Impact of early human milk on sepsis and health-care costs in very low birth weight infants

Objective:to study the incidence of sepsis and neonatal intensive care unit (nicu) costs as a function of the human milk (hm) dose received during the first 28 days post birth for very low birth weight (vlbw) infants.study design:prospective cohort study of 175 vlbw infants. the average daily dose of hm (addhm) was calculated from daily nutritional data for the first 28 days post birth (addhm-days 1–28). other covariates associated with sepsis were used to create a propensity score, combining multiple risk factors into a single metric.result:the mean gestational age and birth weight were 28.1±2.4 weeks and 1087±252 g, respectively. the mean addhm-days 1–28 was 54±39 ml kg−1 day−1 (range 0–135). binary logistic regression analysis controlling for propensity score revealed that increasing addhm-days 1–28 was associated with lower odds of sepsis (odds ratio 0.981, 95% confidence interval 0.967–0.995, p=0.008). increasing addhm-days 1–28 was associated with significantly lower nicu costs.conclusion:a dose–response relationship was demonstrated between addhm-days 1–28 and a reduction in the odds of sepsis and associated nicu costs after controlling for propensity score. for every hm dose increase of 10 ml kg−1 day−1, the odds of sepsis decreased by 19%. nicu costs were lowest in the vlbw infants who received the highest addhm-days 1–28.