A retrospective study on the effects of exclusive donor human milk feeding in a short period after birth on morbidity and growth of preterm infants during hospitalization

ObjectiveTo summarise current evidence evaluating the effects of human milk on the risk of bronchopulmonary dysplasia (BPD) in preterm infants.DesignWe searched for studies on human milk and BPD in English and Chinese databases on 26 July 2017. Furthermore, the references of included studies were also screened. The inclusion criteria in this meta-analysis were the following: (1) preterm infants (<37 weeks); (2) human milk; (3) comparing with formula feeding; (4) the outcome included BPD; and (5) the type of study was randomised controlled trial (RCT) or cohort study.ResultA total of 17 cohort studies and 5 RCTs involving 8661 preterm infants met our inclusion criteria. The ORs and 95% CIs of six groups were as follows: 0.78 (0.68 to 0.88) for exclusive human milk versus exclusive formula group, 0.77 (0.68 to 0.87) for exclusive human milk versus mainly formula group, 0.76 (0.68 to 0.87) for exclusive human milk versus any formula group, 0.78 (0.68 to 0.88) for mainly human milk versus exclusive formula group, 0.83 (0.69 to 0.99) for mainly human milk versus mainly formula group and 0.82 (0.73 to 0.93) for any human milk versus exclusive formula group. Notably, subgroup of RCT alone showed a trend towards protective effect of human milk on BPD but no statistical significance.ConclusionBoth exclusive human milk feeding and partial human milk feeding appear to be associated with lower risk of BPD in preterm infants. The quality of evidence is low. Therefore, more RCTs of this topic are needed.

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Impact of Donor Human Milk in the Preterm Very Low Birth Weight Gut Transcriptome Profile by Use of Exfoliated Intestinal Cells

Nutrients ◽

10.3390/nu11112677 ◽

2019 ◽

Vol 11 (11) ◽

pp. 2677 ◽

Cited By ~ 1

Author(s):

Anna Parra-Llorca ◽

María Gormaz ◽

Sheila Lorente-Pozo ◽

Maria Cernada ◽

Ana García-Robles ◽

...

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Very Low Birth Weight ◽

Principal Component ◽

Postnatal Period ◽

Intestinal Cells ◽

Donor Human Milk ◽

Genome Wide ◽

Alpha Gene ◽

Cytosolic Factor

Background: Own mother’s milk (OMM) is the optimal nutrition for preterm infants. However, pasteurized donor human milk (DHM) is a valid alternative. We explored the differences of the transcriptome in exfoliated epithelial intestinal cells (EEIC) of preterm infants receiving full feed with OMM or DHM. Methods: The prospective observational study included preterm infants ≤ 32 weeks’ gestation and/or ≤1500 g birthweight. Total RNA from EEIC were processed for genome-wide expression analysis. Results: Principal component analysis and unsupervised hierarchical clustering analysis revealed two clustered groups corresponding to the OMM and DHM groups that showed differences in the gene expression profile in 1629 transcripts. The OMM group overexpressed lactalbumin alpha gene (LALBA), Cytochrome C oxidase subunit I gene (COX1) and caseins kappa gene (CSN3), beta gene (CSN2) and alpha gene (CSN1S1) and underexpressed Neutrophil Cytosolic Factor 1 gene (NCF1) compared to the DHM group. Conclusions: The transcriptomic analysis of EEIC showed that OMM induced a differential expression of specific genes that may contribute to a more efficient response to a pro-oxidant challenge early in the postnatal period when preterm infants are at a higher risk of oxidative stress. The use of OMM should be strongly promoted in preterm infants.

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Human Milk Feeding Status of Preterm Infants in Neonatal Intensive Care Units in China

Journal of Human Lactation ◽

10.1177/0890334419901265 ◽

2020 ◽

Vol 36 (2) ◽

pp. 283-290 ◽

Cited By ~ 1

Author(s):

Wenjing Peng ◽

Siyuan Jiang ◽

Shujuan Li ◽

Shiwen Xia ◽

Shushu Chen ◽

...

Keyword(s):

Intensive Care ◽

Human Milk ◽

Intensive Care Units ◽

Preterm Infants ◽

Significant Variation ◽

Neonatal Intensive Care ◽

Current Status ◽

Neonatal Intensive Care Units ◽

Feeding Rates ◽

Milk Feeding

Background Previous low human milk feeding rates in Chinese neonatal intensive care units of preterm infants were reported. There are no nationwide data on these. Research Aims To investigate the current status of human milk feeding for preterm infants in Chinese units and provide baseline data for future research. Methods A secondary data analysis was conducted from a previously established clinical database including 25 Chinese neonatal intensive care units. All infants born <34 weeks gestation and admitted to participating units from May 2015 to April 2018 were enrolled. Variables analyzed were infant data collected and the human milk feeding practices at participating units were surveyed. Results A total of 24,113 infants were included. The overall and exclusive human milk feeding rates were 58.2% and 18.8%, respectively, which increased significantly during study years. We found that rates of human milk feeding decreased with increase in gestational age and birth weight. There was significant variation in human milk feeding rates among units. Most participating Chinese neonatal intensive care units have taken measures to improve the rates of human milk feeding. Conclusions The human milk feeding rates in Chinese neonatal intensive care units have continued to increase in the past 3 years, but there was significant variation among them. More efforts are needed to further increase the human milk feeding rates in China. Trial registration This study was registered NCT02600195 with clinicaltrials.gov on November 9, 2015.

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Donor Human Milk for Preterm Infants

PEDIATRICS ◽

10.1542/peds.2012-1647c ◽

2012 ◽

Vol 130 (2) ◽

pp. e462-e462 ◽

Cited By ~ 3

Author(s):

W. McGuire

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Donor Human Milk

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Evidence-Based Methods That Promote Human Milk Feeding of Preterm Infants

Clinics in Perinatology ◽

10.1016/j.clp.2016.11.005 ◽

2017 ◽

Vol 44 (1) ◽

pp. 1-22 ◽

Cited By ~ 59

Author(s):

Paula P. Meier ◽

Tricia J. Johnson ◽

Aloka L. Patel ◽

Beverly Rossman

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Evidence Based ◽

Milk Feeding

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Donor human milk for preterm infants: Practice considerations

Journal of Neonatal Nursing ◽

10.1016/j.jnn.2013.04.002 ◽

2013 ◽

Vol 19 (4) ◽

pp. 175-181 ◽

Cited By ~ 6

Author(s):

Sharyn Gibbins ◽

Sabrina E. Wong ◽

Sharon Unger ◽

Deborah O'Connor

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Donor Human Milk

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Circadian Macronutrients Variations over the First 7 Weeks of Human Milk Feeding of Preterm Infants

Breastfeeding Medicine ◽

10.1089/bfm.2015.0053 ◽

2015 ◽

Vol 10 (7) ◽

pp. 366-370 ◽

Cited By ~ 21

Author(s):

Hadar Moran-Lev ◽

Francis B. Mimouni ◽

Amit Ovental ◽

Laurence Mangel ◽

Dror Mandel ◽

...

Keyword(s):

Human Milk ◽

Preterm Infants ◽

Milk Feeding

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Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

10.20944/preprints201801.0107.v1 ◽

2018 ◽

Author(s):

Eduardo Villamor-Martínez ◽

Maria Pierro ◽

Giacomo Cavallaro ◽

Fabio Mosca ◽

Boris W. Kramer ◽

...

Keyword(s):

Systematic Review ◽

Human Milk ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Observational Studies ◽

Meta Analysis ◽

Very Preterm Infants ◽

Very Preterm ◽

Donor Human Milk ◽

Preterm Formula

Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if mother’s own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCT’s could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (3 studies, risk ratio [RR] 0.89, 95% confidence interval [CI] 0.60–1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (3 studies, RR 0.80, 95% CI 0.68–0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (2 studies, RR 0.77, 95% CI 0.62–0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants, but pasteurization of human milk reduces the benefit.

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