Antibiotic-resistant bacteria are an increasing problem in the NICU. Ineffective empiric antibiotic therapy is associated with increased risk for morbidity and mortality. Organisms that are resistant to multiple antimicrobial agents (multidrug-resistant organisms) are particularly problematic. These organisms may be transmitted to infants if infection control practices are not adhered to, or they may be created by antibiotic exposure. Therefore, meticulous infection prevention—including hand hygiene, surveillance cultures, contact precautions, and selective decolonization—and antibiotic stewardship are important strategies to minimize drug resistance in the NICU.

Objective: To compare body composition and growth in very low birth weight infants according to their source of human milk: maternal expressed breast milk (MEBM) versus donor breast milk (DBM). We hypothesized that infants fed predominately MEBM would exhibit reduced body fat percentage compared to those fed predominately DBM. Methods: Premature infants weighing ≤1500g on an exclusive human milk diet were enrolled in a single-center study between 2017 and 2021. Demographic data and anthropometric measurements were collected. All infants underwent body composition analysis via dual energy x-ray absorptiometry at 36 weeks corrected post menstrual age. Results: 60 infants were enrolled and 48 were included in the primary analysis. No differences were detected in percent body fat (14% vs.12%, p=0.7) or fat-free mass (2050g vs. 2130g p=0.7). Both groups displayed similar growth and anthropometric measurements. Caloric and macronutrient intake between groups was similar. Conclusion: In the cohort of patients studied, no differences were observed in percent body fat based on primary human milk type intake in the first 28 postnatal days. Further investigation is required in a larger population of exclusive human milk fed preterm infants to determine if body composition differences exist based on an infant’s primary human milk source.

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