Necrotizing Enterocolitis and Human Milk Feeding

Cacho, Nicole; Parker, Leslie A.; Neu, Josef

doi:10.1016/j.clp.2016.11.009

Cited by 97 publications

(74 citation statements)

References 61 publications

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“…[13][14][15][16][17] Human milk has also been shown to improve psychomotor development of full term and preterm infants later in life, including cognitive, social, language, gross motor, and fine motor skills. [18][19][20][21][22][23] Specifically among preterm infants, breast milk has also been associated with a decreased incidence of common neonatal complications, including necrotizing enterocolitis, [24][25][26][27] retinopathy of prematurity, 28,29 and sepsis. 30 The mechanisms underlying the effects of human breast milk on the immune system are likely multifactorial.…”

mentioning

confidence: 99%

Impact of breast milk on respiratory outcomes in infants with bronchopulmonary dysplasia

Kim

McGrath‐Morrow

Collaco

2019

Pediatric Pulmonology

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Background The objective of our study was to examine whether outpatient respiratory morbidities in infants with bronchopulmonary dysplasia (BPD) are influenced by the human milk consumption. Methods Caregivers of subjects recruited from a BPD clinic completed questionnaires regarding breast milk intake and respiratory outcomes. Results One‐hundred eighty‐eight caregivers completed the questionnaire. Of these, 173 (92.0%) reported that the child received some breast milk. Infants who received breast milk for fewer months were more likely to be non‐white, and have a lower household income, public insurance, and secondhand smoke exposure. A longer receipt of breast milk was associated with reduced likelihoods of emergency department visits, systemic steroid courses, and cough or chest congestion, and a trend towards a lower risk of re‐hospitalizations. Conclusions Longer duration of breast milk intake was associated with markers of higher socio‐economic status, and reduced likelihood of acute and chronic respiratory morbidities among preterm infants with bronchopulmonary dysplasia.

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confidence: 99%

Impact of breast milk on respiratory outcomes in infants with bronchopulmonary dysplasia

Kim

McGrath‐Morrow

Collaco

2019

Pediatric Pulmonology

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“…There are several hypothetical mechanisms by which human milk may exert a protective effect against BPD: (i) by improving the nutritional status and growth of the infants; (ii) by reducing postnatal inflammatory processes such as NEC and LOS; (iii) by modulating the immune functions; and (iv) through the antioxidant properties of human milk. However, the term human milk feeding is frequently used to encompass both MOM and DHM, implying that the multiple beneficial outcomes attributed to MOM can be generalized to DHM [13,14]. This assumption may not be correct because of the important differences between DHM and MOM.…”

Section: Discussionmentioning

confidence: 99%

“…Although evidence exists regarding the protective effects of MOM in reducing the risk of necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and retinopathy of prematurity (ROP) in VLBW infants, questions remain regarding whether DHM provides the same benefits [5,[8][9][10][11][12][13][14]. Numerous MOM components which could contribute to protect against adverse outcomes of prematurity are reduced or absent in DHM which is usually pasteurized [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Villamor-Martínez

Pierro

Cavallaro

et al. 2018

Preprint

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Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if mother’s own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCT’s could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (3 studies, risk ratio [RR] 0.89, 95% confidence interval [CI] 0.60–1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (3 studies, RR 0.80, 95% CI 0.68–0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (2 studies, RR 0.77, 95% CI 0.62–0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants, but pasteurization of human milk reduces the benefit.

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“…Breast milk contains many protective factors, including bactericidal, immunologic, antioxidant, and anti-inflammatory properties. (31) Maternal white blood cells, lysozymes, secretory immunoglobulin A, various growth factors, lactoferrin, oligosaccharides, and commensal bacteria are among its protective factors. (32)(33) Although breast milk use has multiple desirable benefits, including reduction in some of the catastrophic comorbidities experienced with prematurity, without fortification, it can be suboptimal for growth and nutritional balance for the rapidly growing premature infant.…”

Section: Breast Milk (Mother's Own Milk and Donor Milk) Versus Formulamentioning

confidence: 99%

Influences of Feeding on Necrotizing Enterocolitis

Thompson-Branch

Havranek

2018

NeoReviews

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Despite the recognition that enteral feeding and some clinical conditions encountered during the management of prematurity may affect the development of necrotizing enterocolitis (NEC) in premature neonates, there is still significant variation in practice. Clinicians should be aware of the current evidence regarding feeding and the development of NEC in premature neonates, specifically relating to the use of breast milk, feeding when a patent ductus arteriosus is present and during its treatment, as well as the potential association of NEC with anemia and red blood cell transfusions. AbstractNecrotizing enterocolitis (NEC) remains one of the leading complications of prematurity with an incidence of 5% to 13% and a mortality of up to 30%. Its occurrence is inversely related to gestational age, with the most premature neonates being at highest risk. Despite numerous studies assessing risk factors, the most commonly observed associations remain prematurity and enteral feeding. Furthermore, studies have pointed to receipt of breast milk as a protective factor in decreasing the risk of NEC and formula feeding as potentially increasing the risk. Other potential risk factors and associations in the premature infant include lack of antenatal steroids, receipt of prolonged courses of postnatal antibiotics, presence of anemia, receipt of packed red blood cell transfusions, and presence of a patent ductus arteriosus. Despite the recognition that NEC remains a serious complication of prematurity, there is still no specific prescription for its prevention. Given that enteral feeding is one of the most commonly observed risk factors for the development of NEC, wide variation exists in the enteral feeding recommendations and practices for premature infants. Feeding practices that may contribute to NEC, which remain variable in practice, include feeding strategies used in the presence of a hemodynamically significant patent ductus arteriosus and feeding during packed red blood cell transfusions. Use of breast milk (mother's own milk or donor milk) is recognized as one of the mainstays of NEC prevention. This article explores multiple influences of feeding on the development of NEC.

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Necrotizing Enterocolitis and Human Milk Feeding

Cited by 97 publications

References 61 publications

Impact of breast milk on respiratory outcomes in infants with bronchopulmonary dysplasia

Impact of breast milk on respiratory outcomes in infants with bronchopulmonary dysplasia

Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Influences of Feeding on Necrotizing Enterocolitis

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