title: Human Milk Feeding as a Protective Factor for Retinopathy of Prematurity: A Meta-analysis.
abstract: BACKGROUND
  Studies have suggested that human milk feeding decreases the incidence of retinopathy of prematurity (ROP); however, conflicting results have been reported.
  
  
  OBJECTIVE
  The aim of this meta-analysis was to pool currently available data on incidence of ROP in infants fed human milk versus formula.
  
  
  METHODS
  Medline, PubMed, and EBSCO were searched for articles published through February 2015.
  
  
  METHODS
  Longitudinal studies comparing the incidence of ROP in infants who were fed human milk and formula were selected. Studies involving donor milk were not included.
  
  
  METHODS
  Two independent reviewers conducted the searches and extracted data. Meta-analysis used odds ratios (ORs), and subgroup analyses were performed.
  
  
  RESULTS
  Five studies with 2208 preterm infants were included. Searches including various proportions of human milk versus formula, any-stage ROP, and severe ROP were defined to pool data for analyses. For any-stage ROP, the ORs (95% confidence intervals [CIs]) were as follows: exclusive human milk versus any formula, 0.29 (0.12 to 0.72); mainly human milk versus mainly formula, 0.51 (0.26 to 1.03); any human milk versus exclusive formula, 0.54 (0.15 to 1.96); and exclusive human milk versus exclusive formula, 0.25 (0.13 to 0.49). For severe ROP, they were 0.11 (0.04 to 0.30), 0.16 (0.06 to 0.43), 0.42 (0.08 to 2.18), and 0.10 (0.04 to 0.29), respectively.
  
  
  CONCLUSIONS
  Prospective randomized studies being impossible because of ethical issues, we chose observational studies for analysis. A few studies involving subgroup analyses presented high heterogeneity.
  
  
  CONCLUSIONS
  Based on current limited evidence, in very preterm newborns, human milk feeding potentially plays a protective role in preventing any-stage ROP and severe ROP.
authors.affiliation: Children's Hospital of Fudan University, Shanghai, China;
authors.forename: Jianguo
authors.initials: J
authors.lastname: Zhou
authors.affiliation: The Hospital for Sick Children, Toronto, Canada; and.
authors.forename: Vivek V
authors.initials: VV
authors.lastname: Shukla
authors.affiliation: People's Open Access Education Initiative, Manchester, United Kingdom.
authors.forename: Denny
authors.initials: D
authors.lastname: John
authors.affiliation: Children's Hospital of Fudan University, Shanghai, China; chen6010@163.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Chen
mesh_terms: D006801:Humans; D015994:Incidence; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D008895:Milk, Human; D016017:Odds Ratio; D065840:Protective Factors; D012178:Retinopathy of Prematurity / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index