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The Effect of Maternal Milk on Neonatal Morbidity of Very Low-Birth-Weight Infants
Lydia Furman, MD;
Gerry Taylor, PhD;
Nori Minich, BS;
Maureen Hack, MB ChB
Arch Pediatr Adolesc Med. 2003;157:66-71.
Objective To examine the dose effect of maternal milk on neonatal morbidity of very low-birth-weight (<1.5 kg) infants.
Design Prospective observational study.
Setting An urban tertiary care neonatal intensive care unit and follow-up clinic.
Population One hundred nineteen singleton very low-birth-weight infants admitted from January 1, 1997, to February 14, 1999 (mean birth weight, 1056 g; mean gestational age, 28 weeks; 57% male; and 43% white).
Methods A comparison of the effect on neonatal outcomes of daily graded doses (1-24, 25-49, and  50 mL/kg of body weight) of maternal milk through week 4 of life vs a reference group receiving no maternal milk.
Main Outcome Measures Neonatal outcomes examined included rates of sepsis after age 5 days, retinopathy of prematurity, chronic lung disease, necrotizing enterocolitis, jaundice, duration of ventilator dependence, and length of hospital stay.
Results Seventy-nine infants (66%) received maternal milk, of whom 32 received at least 50 mL/kg per day through week 4 of life. Poisson regression analysis adjusting for birth weight, sex, and ethnicity revealed that the mean number of episodes of sepsis for infants receiving at least 50 mL/kg per day was lower by a factor of 0.27 (95% confidence interval, 0.08-0.95) compared with infants receiving no maternal milk. There was no effect of maternal milk on other neonatal outcomes.
Conclusions A daily threshold amount of at least 50 mL/kg of maternal milk through week 4 of life is needed to decrease the rate of sepsis in very low-birth-weight infants, but maternal milk does not affect other neonatal morbidities.
From the Department of Pediatrics, Case Western Reserve University, and Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio.
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