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Greater mortality and morbidity in extremely preterm infants fed a diet containing cow milk protein products

Steven A Abrams1, Richard J Schanler, Martin L Lee

  • 11 Children's Nutrition Research Center, U.S. Department of Agriculture, Agricultural Research Service; and Department of Pediatrics, Baylor College of Medicine , Houston, Texas.

Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine
|May 29, 2014
PubMed

Insights

An exclusive human milk diet significantly reduced mortality and necrotizing enterocolitis in extremely preterm infants. This approach to nutritional care is recommended for improving health outcomes.

Area of Science:

  • Neonatal Nutrition
  • Pediatric Gastroenterology
  • Perinatal Medicine

Background:

  • Human milk provision is critical for extremely preterm (EP) infants' health.
  • Neonatal intensive care unit (NICU) stays present unique nutritional challenges for EP infants.
  • Evaluating exclusive human milk diets is essential for optimizing EP infant outcomes.

Purpose of the Study:

  • To assess the impact of an exclusive human milk diet on EP infant health during NICU hospitalization.
  • To compare outcomes between EP infants receiving human milk fortified with human milk protein versus those receiving cow milk-based protein.

Main Methods:

  • EP infants (<1,250g birth weight) were assigned to either a human milk (HM) diet (n=167) or a diet with cow milk-based (CM) protein (n=93).
  • Primary outcomes included mortality, necrotizing enterocolitis (NEC), growth, and duration of parenteral nutrition (PN).

Main Results:

  • Mortality rates were significantly lower in the HM group (2%) compared to the CM group (8%).
  • Necrotizing enterocolitis (NEC) incidence was significantly lower in the HM group (5%) versus the CM group (17%).
  • Increased CM intake correlated with a higher risk of sepsis, and reduced PN duration was observed with <10% CM intake.

Conclusions:

  • An exclusive human milk diet, excluding CM-containing products, is linked to reduced mortality and morbidity in EP infants.
  • This nutritional strategy supports EP infant health without negatively impacting growth.
  • Exclusive human milk feeding should be strongly considered for nutritional care in EP infants.
Abstract

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