More evidence: Mothers’ own milk is personalized medicine for very low birthweight infants

Meier, Paula P.

doi:10.1016/j.xcrm.2022.100710

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…Preterm infants are a high-risk population, and prematurity is a leading cause of neonatal morbidity and mortality. Feeding with breast milk during the first days and months is one of the most impactful factors on the health of these vulnerable infants, as it reduces the incidence and severity of complications associated with prematurity and their related costs [15][16][17]. In addition, exposure to MOM, particularly in the first weeks of life, also improves long-term outcomes, especially the neurodevelopment [18][19][20], and reduces disease and rehospitalization rates in the first year of life [17].…”

Section: Discussionmentioning

confidence: 99%

Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge

Quitadamo

Zambianco²,

Palumbo

et al. 2023

Nutrients

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Mothers’ own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for infants weighing <1500 g for a period of 5 years, evaluating the trend over time and the impact of some variables on human milk feeding performance. Statistical comparisons concerned the rate of feeding with breast milk during a stay in an NICU and at discharge with respect to two types of variables: (1) maternal and neonatal characteristics (gestational age, birth weight, type of pregnancy (whether single or twin), maternal age) and (2) feeding characteristics (time of the start of minimal enteral feeding and availability of MOM, days until the achievement of full enteral feeding). Group comparisons were performed using ANOVA or t-test for continuous variables and Pearson chi-squared test or Fisher exact test for categorical variables. We observed an increase, between 2017 and 2021, in MOM use (p = 0.003). The availability of the own mothers’ milk occurred, on average, on the fourth day of life and improved over the years. The start of minimal enteral feeding (MEF) with human milk averaged 1.78 days, and 54.3% of VLBWs received MEF with donor milk on the first day of life. The average percentage of feeding with the mothers’ milk at discharge was 47.6%, with 36.1% of exclusive MOM and an increase from 45.8% in 2017 (33.3% exclusive) to 58.82% (41.18% exclusive) in 2021. The mean average daily growth of the weight improved (p < 0.001) during this period, and there was no statistical difference between infants fed with maternal milk and those fed with bank milk. Older maternal age, early-start feeding with maternal milk and low gestational age had a statistically significant impact on feeding with MOM at discharge.

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Section: Discussionmentioning

confidence: 99%

Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge

Quitadamo

Zambianco²,

Palumbo

et al. 2023

Nutrients

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“…While there are many barriers to achieving fresh human milk feeding based on parental circumstances and hospital practices, it is essential to note that the few studies that have been conducted have found health benefits with as little as one fresh feeding per day [13,41]. Collaborative discussions with families about the potential benefits of fresh parent's own milk can empower them to recognize that their milk is a personalized medicine for their infant [51] and encourage parents to prioritize pumping at the bedside as often as possible to provide fresh parent's own milk. In the future, more work is needed to address disparities in the ability of all families to be present in the NICU independent of other factors (e.g., economic, family, social).…”

Section: What Can We Do Today?mentioning

confidence: 99%

Fresh Parent’s Own Milk for Preterm Infants: Barriers and Future Opportunities

Briere,

Gomez

2024

Nutrients

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While direct at-the-breast feeding is biologically optimal, Neonatal Intensive Care Unit (NICU) admission due to infant immaturity or illness often necessitates the expression and storage of parent’s milk. The provision of freshly expressed (never stored) parent’s own milk to preterm infants is not widely prioritized, and this article provides an exploration of NICU practices and their implications for feeding premature or ill infants with parent’s own milk. In this article, we discuss the potential biological benefits of fresh parent’s own milk, highlighting its dynamic components and the changes incurred during storage. Research suggests that fresh milk may offer health advantages over stored milk. The authors advocate for further research, emphasizing the need for standardized definitions. Research is needed on the biological impact of fresh milk, both short- and long-term, as well as defining and understanding healthcare economics when using fresh milk.

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“…2 High-dose pasteurized donor human milk (PDHM) is an inferior substitute, so understanding the origins of insu cient MOM is a research priority. 3 Insu cient MOM volume in this population can often be traced to the rst 14 days postpartum, a critical timeframe that includes the achievement of secretory activation (SA; lactogenesis II, milk coming in) and coming to volume (CTV; 500 mL/day of pumped MOM), both of which predict MOM feedings at NICU discharge in very low birthweight (VLBW; <1500 grams birthweight) preterm infants. [4][5][6][7] There is strong evidence that the mammary gland undergoes programming during this early post-birth window, during which interventions to optimize long-term MOM volume may be most effective.…”

Section: Introductionmentioning

confidence: 99%

Early Pumping Behaviors Predict Pumped Milk Volume, Achievement of Secretory Activation and Coming to Volume in Breast Pump-Dependent Mothers of Preterm Infants

Median-Poeliniz,

Hoban,

Signorile

et al. 2024

Preprint

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Objective: Pumping studies in mothers of preterm infants are limited by self-reported pumping behaviors and non-objective measures of pumped milk volume and secretory activation (SA). Study Design: Non-randomized observational study of first 14 days postpartum in 29 mothers of preterm infants. Smart pumps measured and stored pumping behaviors and pumped milk volume. Selective ion electrodes measured sodium and sodium:potassium ratio to determine SA. Generalized estimating equations, cluster analyses and multivariate regression were used. Results: SA was delayed (median 5.8 days) and impermanent. Each additional daily pumping increased odds of SA within 2 days by 48% (p=.01). High-intensity pumping mothers (N=17) had greater daily and cumulative pumped milk volume than low-intensity pumping mothers (N=12). Pumping variables showed daily changes in the first week, then plateaued. Conclusion: The first week postpartum is critical for optimizing pumping behaviors. Accurate, objective measures of pumping behaviors, pumped milk volume and SA are a research priority.

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More evidence: Mothers’ own milk is personalized medicine for very low birthweight infants

Cited by 11 publications

References 10 publications

Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge

Trend and Predictors of Breastmilk Feeding among Very-Low-Birth-Weight Infants in NICU and at Discharge

Fresh Parent’s Own Milk for Preterm Infants: Barriers and Future Opportunities

Early Pumping Behaviors Predict Pumped Milk Volume, Achievement of Secretory Activation and Coming to Volume in Breast Pump-Dependent Mothers of Preterm Infants

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