Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia?

Spiegler, Juliane; Preuß, Michael; Gebauer, Corinna; Bendiks, Meike; Herting, Egbert; Göpel, Wolfgang; Berghäuser, Martin A.; Böckenholt, Kai; Bohnhorst, Bettina; Böttger, Ralf; Brune, Thomas; Dawczynski, K; Dördelmann, Michael; Ehlers, Silke; Eichhorn, Joachim; Felderhoff-Müser, Ursula; Franz, Axel; Gerleve, Hubert; Gortner, Ludwig; Haase, Roland; Heitmann, Friedhelm; Hentschel, Roland; Hepping, Nico; Hillebrand, Georg; Höhn, T.; Hörnig-Franz, Isabelle; Hubert, Mechthild; Jenke, Andreas; Jensen, Rainer; Kannt, O.; H, Körner; Kribs, Angela; Küster, Helmut; Linnemann, Knud; Möller, Jens; Müller, Andreas; Müller, D.; Olbertz, Dirk; Orlikowsky, Thorsten; Reese, Jochen; Roll, Claudia; Rossi, Rainer; Rüdiger, Mario; Schaible, Thomas; Schiffmann, Jan-Holger; Schmidkte, Susanne; Seeliger, Stephan; Segerer, Hugo; Siegel, Jens; Teig, Norbert; Urlichs, F.; Wense, A. von der; Vochem, Matthias; Weller, Ursula; Wieg, Christian; Wintgens, Jürgen

doi:10.1016/j.jpeds.2015.10.080

Cited by 136 publications

(139 citation statements)

References 28 publications

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“…Data from the German Neonatal Network, however, showed that exclusively formula-fed infants had 2.6-times the risk of developing BPD in multivariate analysis than exclusively breastmilk-fed infants 56. In another cohort study, multivariable analysis showed a 9.5% reduction in the odds of BPD for every 10% increase in expressed breastmilk 57.…”

Section: Introductionmentioning

confidence: 93%

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Poets

Lorenz

2018

Arch Dis Child Fetal Neonatal Ed

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Bronchopulmonary dysplasia (BPD) is one of the most frequent complications in extremely low gestational age neonates, but has remained largely unchanged in rate. We reviewed data on BPD prevention focusing on recent meta-analyses. Interventions with proven effectiveness in reducing BPD include the primary use of non-invasive respiratory support, the application of surfactant without endotracheal ventilation and the use of volume-targeted ventilation in infants requiring endotracheal intubation. Following extubation, synchronised nasal ventilation is more effective than continuous positive airway pressure in reducing BPD. Pharmacologically, commencing caffeine citrate on postnatal day 1 or 2 seems more effective than a later start. Applying intramuscular vitamin A for the first 4 weeks reduces BPD, but is expensive and painful and thus not widely used. Low-dose hydrocortisone for the first 10 days prevents BPD, but was associated with almost twice as many cases of late-onset sepsis in infants born at 24-25 weeks' gestation. Inhaled corticosteroids, despite reducing BPD, were associated with a higher mortality rate. Administering dexamethasone to infants still requiring mechanical ventilation around postnatal weeks 2-3 may represent the best trade-off between restricting steroids to infants at risk of BPD while still affording high efficacy. Finally, identifying infants colonised with ureaplasma and treating those requiring intubation and mechanical ventilation with azithromycin is another promising approach to BPD prevention. Further interventions yet only backed by cohort studies include exclusive breastmilk feeding and a better prevention of nosocomial infections.

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Section: Introductionmentioning

confidence: 93%

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Poets

Lorenz

2018

Arch Dis Child Fetal Neonatal Ed

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“…These findings are consistent with a recently published prospective cohort study by Spiegler et al comparing premature infants fed exclusive human milk versus exclusive formula. Premature infants who received exclusive human milk had a reduced risk of BPD 4. In addition, OMM has been shown in a dose–response relationship to decrease the rate of NEC or death at 14 days of age in extremely premature infants 5.…”

Section: Commentarymentioning

confidence: 99%

Own mother’s milk significantly decreases the risk of bronchopulmonary dysplasia

Hair

2017

Evid Based Nurs

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“…[14][15][16] However, investigations of the impact of human milk (OMM±donor milk supplementation) on BPD are limited. [17][18][19] The purpose of this study was to investigate the dose-dependent impact of OMM feedings received from birth to 36 weeks PMA on BPD and associated NICU healthcare costs in a contemporary cohort of VLBW infants.…”

Section: Introductionmentioning

confidence: 99%

Influence of own mother's milk on bronchopulmonary dysplasia and costs

Patel

Johnson

Robin

et al. 2016

Arch Dis Child Fetal Neonatal Ed

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Background Human milk from the infant’s mother (own mother’s milk; OMM) feedings reduces the risk of several morbidities in very low birthweight (VLBW) infants, but limited data exist regarding its impact on bronchopulmonary dysplasia (BPD). Objective To prospectively study the impact of OMM received in the neonatal intensive care unit (NICU) on the risk of BPD and associated costs. Design/methods A 5-year prospective cohort study of the impact of OMM dose on growth, morbidity and NICU costs in VLBW infants. OMM dose was the proportion of enteral intake that consisted of OMM from birth to 36 weeks postmenstrual age (PMA) or discharge, whichever occurred first. BPD was defined as the receipt of oxygen and/or positive pressure ventilation at 36 weeks PMA. NICU costs included hospital and physician costs. Results The cohort consisted of 254 VLBW infants with mean birth weight 1027±257 g and gestational age 27.8±2.5 weeks. Multivariable logistic regression demonstrated a 9.5% reduction in the odds of BPD for every 10% increase in OMM dose (OR 0.905 (0.824 to 0.995)). After controlling for demographic and clinical factors, BPD was associated with an increase of US $41 929 in NICU costs. Conclusions Increased dose of OMM feedings from birth to 36 weeks PMA was associated with a reduction in the odds of BPD in VLBW infants. Thus, high-dose OMM feeding may be an inexpensive, effective strategy to help reduce the risk of this costly multifactorial morbidity.

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Does Breastmilk Influence the Development of Bronchopulmonary Dysplasia?

Cited by 136 publications

References 28 publications

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Prevention of bronchopulmonary dysplasia in extremely low gestational age neonates: current evidence

Own mother’s milk significantly decreases the risk of bronchopulmonary dysplasia

Influence of own mother's milk on bronchopulmonary dysplasia and costs

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