title: Policy of feeding very preterm infants with their mother's own fresh expressed milk was associated with a reduced risk of bronchopulmonary dysplasia.
abstract: OBJECTIVE
  Since 2005, the French Food Safety Agency has recommended that very preterm or low-birthweight babies should be fed with pasteurised, expressed breastmilk, and feeding policies on this vary widely in French neonatal units. We investigated the differences between using a mother's expressed milk, in fresh or pasteurised forms, for very preterm infants.
  
  
  METHODS
  This observational multicentre study analysed data on 926 very preterm infants: 636 from neonatal units who used the mother's own fresh milk and 290 who used the mother's milk after pasteurisation. We analysed necrotising enterocolitis, bronchopulmonary dysplasia, in-hospital mortality, late-onset sepsis, weight gain, length of hospital stay, the duration of parenteral nutrition and the duration of enteral feeding with a nasogastric tube. Multivariate analyses were conducted to assess the impact of maternal milk policies.
  
  
  RESULTS
  After adjustment, there was a reduced risk of bronchopulmonary dysplasia in the fresh milk group with an odds ratio of 0.40 and 95% confidence interval of 0.27-0.67 (p < 0.001). No other statistically significant differences were observed.
  
  
  CONCLUSIONS
  Feeding very preterm infants with their mother's expressed fresh milk was associated with a reduced risk of bronchopulmonary dysplasia, and further investigations are needed to evaluate the clinical impact of this practice.
authors.affiliation: Department of Neonatology, Children Hospital, University Hospital, Toulouse, France.|U.1027, INSERM, Toulouse, France.|Paul Sabatier University, Toulouse, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Dicky
authors.affiliation: U.1027, INSERM, Toulouse, France.|Paul Sabatier University, Toulouse, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Ehlinger
authors.affiliation: Department of Neonatology, Children Hospital, University Hospital, Toulouse, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Montjaux
authors.affiliation: Department of Woman, Mother and Child, University Hospital, Brest, France.
authors.forename: Gisèle
authors.initials: G
authors.lastname: Gremmo-Féger
authors.affiliation: Department of Woman, Mother and Child, University Hospital, Brest, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Sizun
authors.affiliation: Department of Neonatal Medicine, University Hospital, Nantes, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Rozé
authors.affiliation: U.1027, INSERM, Toulouse, France.|Paul Sabatier University, Toulouse, France.|Clinical Epidemiology Unit, CHU Purpan, Toulouse, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.affiliation: Department of Neonatology, Children Hospital, University Hospital, Toulouse, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Casper
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology*; D005248:Feeding Methods; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008895:Milk, Human; D061352:Pasteurization; D015430:Weight Gain
keywords: Bronchopulmonary dysplasia; Fresh breastmilk; Neonatal intensive care unit; Pasteurisation; Very preterm infants