The effect of maternal milk on neonatal morbidity of very low-birth-weight infants.
OBJECTIVE
To examine the dose effect of maternal milk on neonatal morbidity of very low-birth-weight (<1.5 kg) infants.


METHODS
Prospective observational study.


METHODS
An urban tertiary care neonatal intensive care unit and follow-up clinic.


METHODS
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 > or = 50 mL/kg of body weight) of maternal milk through week 4 of life vs a reference group receiving no maternal milk.


METHODS
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.
Furman
Lydia
L
Department of Pediatrics, Case Western Reserve University, and Rainbow Babies and Children's Hospital, University Hospitals of Cleveland, Cleveland, Ohio, USA. lmfurman@att.net
Taylor
Gerry
G
Minich
Nori
N
Hack
Maureen
M
D005260:Female; D006801:Humans; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D008895:Milk, Human; D016012:Poisson Distribution; D018805:Sepsis / Q000517:prevention & control