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Sci Rep. 2019 Jan 30;9(1):941. doi: 10.1038/s41598-018-37111-7.

Testing the feasibility and safety of feeding preterm infants fresh mother's own milk in the NICU: A pilot study.

Sun H1,2,3, Han S4, Cheng R5, Hei M6,7, Kakulas F8, Lee SK9,10,11.

Author information

1
Department of Neonatology, Children's Hospital of Zhengzhou University, Zhengzhou, China.
2
Department of Neonatology, Henan Children's Hospital, Zhengzhou, China.
3
Department of Neonatology, Zhengzhou Children's Hospital, Zhengzhou, China.
4
Department of Pediatrics, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
5
Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China.
6
Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China.
7
Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China.
8
Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
9
Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. Shoo.Lee@sinaihealthsystem.ca.
10
Department of Paediatrics, Department of Obstetrics & Gynecology, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Shoo.Lee@sinaihealthsystem.ca.
11
Department of Paediatrics, Sinai Health System, Toronto, Ontario, Canada. Shoo.Lee@sinaihealthsystem.ca.

Abstract

Necrotizing enterocolitis (NEC) is the leading cause of death among infants born at <30 weeks' gestation, but donor human milk can reduce the incidence of NEC. Unfortunately, freezing or pasteurizing human milk deactivates beneficial bioactive components. We evaluated the feasibility, safety, and impact of feeding very preterm infants fresh (unprocessed) mother's own milk within 4 hours of expression. In our multicentre prospective cohort analytic study, we fed 109 control and 98 intervention infants previously frozen donor or mother's own milk; only the intervention group was fed fresh mother's own milk once daily from enrollment until 32 weeks' corrected age. Control group mothers could not commit to provide fresh milk daily and were less likely receive antenatal corticosteroids than mothers in the intervention group. In the intervention group, 87.5% (98/112) of mothers were able to provide at least one feed of fresh milk a day. No critical incidents or non-compliance with the protocol were reported. The duration of mechanical ventilation and total parenteral nutrition use were shorter in the intervention group than controls (P < 0.01) but the length of hospital stay was similar (P = 0.57). Although the study might be underpowered, the intervention group had lower unadjusted rates of the composite outcome NEC ≥ stage 2 or mortality (8% vs 20%, P = 0.04), sepsis (22% vs 38%, P = 0.02), retinopathy of prematurity (17% vs 39%, P < 0.01) and bronchopulmonary dysplasia (32% vs 47%, P < 0.01) than the control. These results indicated that feeding fresh mother's own milk once daily was safe, feasible, and may reduce morbidity.

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