Infant feeding and criticality in children

Area of Science:

• Pediatric critical care medicine
• Neonatal nutrition
• Respiratory medicine

Background:

• Human breast milk (HBM) is known to protect against acute illness in infants.
• The impact of HBM feeding on the criticality and recovery of infants with acute respiratory failure (ARF) is not well understood.

Purpose of the Study:

• To investigate the association between early HBM feeding and illness severity and recovery in critically ill children requiring mechanical ventilation for ARF.

Main Methods:

• A prospective cohort study involving mothers of infants aged 1-36 months who were part of the RESTORE clinical trial.
• Infants required intubation and mechanical ventilation for acute respiratory failure.
• Mothers completed a survey on HBM intake during the first month of life.

Main Results:

• No significant differences in illness severity on pediatric intensive care unit (PICU) admission or pediatric acute respiratory distress syndrome (PARDS) severity were observed between infants receiving exclusive HBM (90%-100%) and those who did not.
• While infants receiving exclusive HBM showed a trend toward a 1-day reduction in recovery time from ARF, this difference was not statistically significant.
• The Pediatric Risk of Mortality (PRISM) III-12 scores and moderate/severe PARDS rates were similar between the exclusive HBM and non-exclusive HBM groups.

Conclusions:

• Early human breast milk feeding dose was not associated with illness severity upon PICU admission for children with ARF requiring mechanical ventilation.
• While not statistically significant, exclusive HBM feeding demonstrated a clinically relevant trend towards faster recovery from ARF, supporting its continued promotion by healthcare professionals.