Nutritional Strategies in Preterm Infants: The Role of Human Milk in Bronchopulmonary Dysplasia

Area of Science:

• Neonatalogy
• Pediatric Pulmonology
• Nutritional Science

Background:

• Bronchopulmonary dysplasia (BPD) is a significant cause of chronic lung disease and growth impairment in premature infants.
• Feeding practices, including the use of mother's own milk (MOM) versus pasteurized donor milk (PDM), are critical in managing infant health and development.
• Understanding the impact of nutritional intake on BPD severity is essential for improving outcomes in vulnerable preterm populations.

Purpose of the Study:

• To compare the incidence of grade 2-3 BPD in preterm infants predominantly fed with MOM versus PDM.
• To investigate the association between nutritional factors and the severity of BPD in this cohort.
• To identify potential risk factors contributing to BPD development and progression.

Main Methods:

• A prospective, single-center study included infants born before 32 weeks' gestation.
• Infants were categorized based on predominant feeding type (>50% MOM or PDM) and BPD severity.
• Nutritional intake, feeding tolerance, timing of fortification, and infant growth were analyzed.

Main Results:

• No significant difference in the incidence of grade 2-3 BPD was observed between the MOM (19%) and PDM (14%) groups.
• Feeding intolerance (44% vs. 11%), delayed nutritional fortification, and slower progression to full enteral feeding were significantly associated with grade 2-3 BPD.
• These factors, rather than milk type, emerged as key indicators of BPD severity.

Conclusions:

• The type of milk (MOM vs. PDM) did not significantly influence the incidence of grade 2-3 BPD.
• Feeding intolerance, delayed nutritional support, and a slower transition to enteral feeding are independent risk factors for severe BPD.
• Optimizing feeding tolerance and ensuring timely nutritional advancement are crucial for mitigating BPD risk in preterm infants.