Using a mother’s own milk to help extremely preterm infants

For extremely preterm infants, mother’s own milk may be helpful for preventing poor postnatal growth and some morbidities.

Medical advancements mean that more and more extremely preterm births result in a living baby. However, these newborns can require additional care to prevent certain complications like retinopathy of prematurity and bronchopulmonary dysplasia, along with poorer postnatal growth. A recent investigation looks at whether using a mother’s own milk leads to lower rates of morbidity than using pasteurized donor milk.1

The investigators looked at a Swedish population-based cohort of extremely preterm infants who were born between 2004 and 2007 and survived. They examined the exposure to both mother’s own milk and pasteurized donor milk from birth until 32 weeks postmenstrual age. The primary outcomes were a change in z-score (Δ) from birth to 32 weeks postmenstrual age for weight, length, and head circumference and the secondary outcomes were the incidence of bronchopulmonary dysplasia and retinopathy of prematurity.

The cohort included 453 infants. The average gestational age 25.4 weeks. The investigators found no links between donor milk and growth outcomes or morbidities, nor was a link found between mother’s own milk and bronchopulmonary dysplasia outcomes. However, mother’s own milk was positively linked to Δweight and Δhead circumference. The link was still significant in multivariable models. Furthermore, each increase of 10 mL of mother’s own milk per kg/day from birth through 32 weeks postmenstrual age would yield an increase of 0.02 (95% CI 0.01–0.03, P < 0.001) z-score units for Δweight and 0.02 (95% CI, +0.00–0.04, P = 0.049) z-score units for Δhead circumference from birth through 32 weeks postmenstrual age. Although it did not carry through to adjusted analyses, a higher intake of mother’s own milk also had a significant link to a lower probably of any form of retinopathy or severe retinopathy.

The investigators concluded that increasing the intake of mother’s own milk and not donor milk or formula was linked to improved head circumference growth and postnatal weight gain from birth until 32 weeks postmenstrual age in infants who were delivered extremely preterm. They urged clinicians to utilize any intervention with a goal of increasing the early intake of mother’s own milk for these extremely preterm infants.

Reference

1. Lund A, Domellöf M, Pivodic A, Hellström A, Stoltz Sjöström E, Hansen-Pupp I. Mother's own milk and its relationship to growth and morbidity in a population-based cohort of extremely preterm infants. J Pediatr Gastroenterol Nutr. 2022;74(2):292-300.doi: 10.1097/MPG.0000000000003352