title: Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia?
abstract: OBJECTIVE
  To assess whether breastmilk feeding is associated with a reduced risk of bronchopulmonary dysplasia (BPD). Secondary outcome measures analyzed were retinopathy of prematurity (ROP) and necrotizing enterocolitis (NEC).
  
  
  METHODS
  In an ongoing multicenter cohort study, the data of 1433 very low birth weight infants born before 32 weeks of gestation and discharged in 2013 were analyzed. We compared growth and neonatal complications of infants who received breastmilk exclusively (N = 223) with those who received formula feedings exclusively (N = 239). Logistic regression models were estimated for BPD, ROP, and NEC using nutrition as an independent variable. The Firth logistic regression model and Lasso were used for sensitivity analyses.
  
  
  RESULTS
  Exclusively breastmilk-fed infants gained less weight compared with formula-fed infants. SDS for weight decreased between birth and discharge (median (Q1-Q3): formula -0.9 (-1.4 to [-0.5]) vs breastmilk -1.1 (-1.7 to [-0.6])). Exclusive formula feeding of very low birth weight infants was associated with increased risks of BPD (OR 2.6) as well as NEC (OR 12.6) and ROP (OR 1.80) after controlling for known risk factors.
  
  
  CONCLUSIONS
  Exclusive breastmilk feeding was associated with lower growth rates and a reduced risk of BPD as well as NEC and ROP.
authors.affiliation: Department of Pediatrics, University of Lübeck, Lübeck, Germany. Electronic address: uni@dr-spiegler.de.
authors.forename: Juliane
authors.initials: J
authors.lastname: Spiegler
authors.affiliation: Institute of Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Preuß
authors.affiliation: Department of Pediatrics, University of Leipzig, Leipzig, Germany.
authors.forename: Corinna
authors.initials: C
authors.lastname: Gebauer
authors.affiliation: Department of Pediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Meike
authors.initials: M
authors.lastname: Bendiks
authors.affiliation: Department of Pediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Egbert
authors.initials: E
authors.lastname: Herting
authors.affiliation: Department of Pediatrics, University of Lübeck, Lübeck, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Göpel
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D015331:Cohort Studies; D020345:Enterocolitis, Necrotizing / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D008895:Milk, Human; D012178:Retinopathy of Prematurity / Q000517:prevention & control*