Am J Perinatol 2012; 29(02): 121-126
DOI: 10.1055/s-0031-1295652
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Human Milk Versus Formula Feeding Among Preterm Infants: Short-Term Outcomes

Ayala Maayan-Metzger
1   Department of Neonatology, The Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
,
Shirli Avivi
1   Department of Neonatology, The Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
,
Irit Schushan-Eisen
1   Department of Neonatology, The Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
,
Jacob Kuint
1   Department of Neonatology, The Edmond and Lili Safra Children’s Hospital, Sheba Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
› Author Affiliations
Further Information

Publication History

30 April 2011

01 August 2011

Publication Date:
17 November 2011 (online)

Abstract

We evaluated short-term neonatal outcomes among preterm infants according to type of feeding administered (human milk or formula). Retrospective data were collected on 400 preterm infants at gestational age ≤32 weeks. Groups were chosen and compared according to feeding type. The premature infants who were fed human milk had lower gestational age and birth weight than those who were formula fed. Lower rates of necrotizing enterocolitis (NEC) were detected in the group of infants fed human milk (p = 0.044). Lower rates of retinopathy of prematurity (ROP) were detected in a subgroup of breast-fed infants born at 24 to 28 weeks’ gestational age, but the results did not reach statistical significance using univariate analysis (p = 0.06). Using multivariate analysis, however, ROP stage III among this subgroup was significantly lower (p = 0.022). No differences were recorded for other neonatal complications such as infections or for growth parameters. The advantage of human milk feeding, found mainly among preterm infants with respect to rates of NEC and ROP, supports efforts to encourage mothers to feed their infants human milk.

 
  • References

  • 1 Vohr BR, Poindexter BB, Dusick AM , et al; NICHD Neonatal Research Network. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118: e115-e123
  • 2 Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet 1992; 339: 261-264
  • 3 Horwood LJ, Darlow BA, Mogridge N. Breast milk feeding and cognitive ability at 7–8 years. Arch Dis Child Fetal Neonatal Ed 2001; 84: F23-F27
  • 4 Jacobson SW, Jacobson JL. Breastfeeding and intelligence. Lancet 1992; 339: 926
  • 5 Lucas A, Cole TJ. Breast milk and neonatal necrotising enterocolitis. Lancet 1990; 336: 1519-1523
  • 6 Updegrove K. Necrotizing enterocolitis: the evidence for use of human milk in prevention and treatment. J Hum Lact 2004; 20: 335-339
  • 7 Sullivan S, Schanler RJ, Kim JH , et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr 2010; 156: 562-567, e1
  • 8 Hylander MA, Strobino DM, Pezzullo JC, Dhanireddy R. Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants. J Perinatol 2001; 21: 356-362
  • 9 Hylander MA, Strobino DM, Dhanireddy R. Human milk feedings and infection among very low birth weight infants. Pediatrics 1998; 102: E38
  • 10 Howie PW, Forsyth JS, Ogston SA, Clark A, Florey CD. Protective effect of breast feeding against infection. BMJ 1990; 300: 11-16
  • 11 Bier Jo-Ann B, Oliver TL, Ferguson A, Vohr BR. Human milk reduces outpatient infections in very low birth weight infants. Pediatr Res 1999; 45: 120A
  • 12 Henderson G, Anthony MY, McGuire W. Formula milk versus maternal breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev 2007; ;( (4) CD002972
  • 13 Quigley MA, Henderson G, Anthony MY, McGuire W. Formula milk versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev 2007; ;( (4) CD002971
  • 14 Maayan-Metzger A, Ghanem N, Mazkereth R, Kuint J. Characteristics of neonates with isolated rectal bleeding. Arch Dis Child Fetal Neonatal Ed 2004; 89: F68-F70
  • 15 Christensen RD, Gordon PV, Besner GE. Can we cut the incidence of necrotizing enterocolitis in half—today?. Fetal Pediatr Pathol 2010; 29: 185-198
  • 16 Wiedmeier SE, Henry E, Baer VL , et al. Center differences in NEC within one health-care system may depend on feeding protocol. Am J Perinatol 2008; 25: 5-11
  • 17 Heller CD, O’Shea M, Yao Q , et al; NICHD Neonatal Research Network. Human milk intake and retinopathy of prematurity in extremely low birth weight infants. Pediatrics 2007; 120: 1-9
  • 18 Ledo A, Arduini A, Asensi MA , et al. Human milk enhances antioxidant defenses against hydroxyl radical aggression in preterm infants. Am J Clin Nutr 2009; 89: 210-215
  • 19 Heird WC. The role of polyunsaturated fatty acids in term and preterm infants and breastfeeding mothers. Pediatr Clin North Am 2001; 48: 173-188
  • 20 Garofalo RP, Goldman AS. Cytokines, chemokines, and colony-stimulating factors in human milk: the 1997 update. Biol Neonate 1998; 74: 134-142
  • 21 Porcelli PJ, Weaver Jr RG. The influence of early postnatal nutrition on retinopathy of prematurity in extremely low birth weight infants. Early Hum Dev 2010; 86: 391-396
  • 22 Nagashima K, Itoh K, Kuroume T. Levels of insulin-like growth factor I in full- and preterm human milk in comparison to levels in cow’s milk and in milk formulas. Biol Neonate 1990; 58: 343-346
  • 23 Díaz-Gómez NM, Domenech E, Barroso F. Breast-feeding and growth factors in preterm newborn infants. J Pediatr Gastroenterol Nutr 1997; 24: 322-327
  • 24 Hellström A, Carlsson B, Niklasson A , et al. IGF-I is critical for normal vascularization of the human retina. J Clin Endocrinol Metab 2002; 87: 3413-3416
  • 25 Hellstrom A, Perruzzi C, Ju M , et al. Low IGF-I suppresses VEGF-survival signaling in retinal endothelial cells: direct correlation with clinical retinopathy of prematurity. Proc Natl Acad Sci U S A 2001; 98: 5804-5808