Human milk for low birthweight infants: immunology, nutrition and newer practical technologies

Human milk has a number of unique properties which can be of benefit to high risk low birthweight and preterm infants. Immunological features are of particular importance. Growth is better with the use of the mother's own milk than with pooled bank milk. The quality of the latter can be improved by various measures noted in the text. Growth can be further improved by enriching the milk with human milk factors, powder formula or protein supplements. As breast-feeding is best for infants, the maternal milk supply should be maintained during the hospital stay of infants by frequent expression, galactogogues used where necessary under supervision, encouraging maternal contact with the infant, promotion of suckling initially on the "empty" breast after expression of milk, and subsequently institution of direct breast-feeding. With proper interventions and motivation of both staff and mothers, even very low birthweight infants below 1,500 gm can go on, in time, to exclusive breast-feeding.