A retrospective analysis of the effect of human milk on prevention of necrotizing enterocolitis and postnatal growth

• Published in: Journal of perinatology Vol. 36; no. 3; pp. 221 - 224
• Main Authors: Chowning, R, Radmacher, P, Lewis, S, Serke, L, Pettit, N, Adamkin, D H
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.03.2016; Nature Publishing Group
• Subjects: 692/308/409; 692/499; Analysis; Birth weight; Breast milk; Care and treatment; Demography; Diet; Enterocolitis; Enterocolitis, Necrotizing - diet therapy; Enterocolitis, Necrotizing - mortality; Enterocolitis, Necrotizing - prevention & control; Enterocolitis, Neonatal necrotizing; Enterocolitis, Pseudomembranous; Female; Gastrointestinal diseases; Growth rate; Health aspects; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Very Low Birth Weight - growth & development; Infants; Intensive Care Units, Neonatal; Length of Stay; Low birth weight; Male; Medicine; Medicine & Public Health; Milk, Human; Mortality; Necrosis; Necrotizing enterocolitis; Neonates; original-article; Pediatric Surgery; Pediatrics; Prevention; Retrospective Studies; United States; United States
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2015.179

Objective: The objective of this study is to determine whether the use of donor human milk (DHM) in very low birth weight (VLBW, ⩽1500 g) neonates in a large neonatal intensive care unit (NICU) affected the rate of necrotizing enterocolitis (NEC) or impacted growth. Study Design: This was a retrospective chart review of 550 VLBW neonates following the introduction of DHM as the preferred diet if maternal breast milk (MBM) was not available. Demographics, growth parameters, incidence of NEC or death and days of DHM or MBM were extracted from charts. Result: Compared with infants who received human milk (HM) on fewer than 50% of hospital days, neonates who received HM on ⩾50% of hospital days had equivalent growth outcomes but lower rates of NEC (NEC 3.4 vs 13.5%, P <0.001) and mortality (1.0 vs 4.2%, P =0.017). Growth and NEC rates were inversely correlated with the duration of exposure to HM. Conclusion: HM should always be the diet of choice in preterm infants. DHM is a safe alternative, if MBM is not available. Although the use of HM is associated with lower rates of NEC, growth rates were significantly lower in infants with significant HM intake. The decline in growth rates following the introduction of DHM should draw attention to optimize fortification of all HM feedings.