Postnatal Cytomegalovirus Risk Does Not Outweigh the Benefits of Mother's Raw Milk

Human cytomegalovirus (CMV) establishes lifelong infection, and there is currently no vaccine or cure. Postnatally, infants can acquire the virus by consuming raw breast milk (BM) from seropositive mothers. Most of these infections are asymptomatic and do not result in either short- or long-term adverse health problems. However, preterm infants can experience significant illness, with severity inversely related to their gestational age at the time of infection. Given the risk of symptomatic disease, empirical treatments to prevent viral transmission in BM have been advocated. However, the American Academy of Pediatrics and the World Health Organization recommend feeding preterm infants their mother's raw BM because the health benefits outweigh the risks associated with postnatally acquired CMV infection. This review discusses the health advantages of providing raw mother's BM to preterm infants. It also explains how milk sterilization procedures can alter its nutritional content, leading to impaired growth and increased morbidity in this patient population. Furthermore, it details postnatal CMV infection in preterm infants, including known clinical findings, treatment recommendations, and potential outcomes.