The Effect of Maternal Milk on Neonatal Morbidity of Very Low-Birth-Weight Infants

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Abstract
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.

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