Nutritional Strategies in Preterm Infants: The Role of Human Milk in Bronchopulmonary Dysplasia

Aim Bronchopulmonary dysplasia (BPD) is a major cause of morbidity and impaired growth in preterm infants. This study compared the incidence of grade 2–3 BPD in infants predominantly fed with mother's own milk (MOM) or pasteurised donor milk (PDM) and examined associations between nutrition and BPD severity. Methods Prospective single‐centre study including infants < 32 weeks' gestation admitted between January 2023 and June 2024. Infants were classified by predominant feeding type (> 50% MOM or PDM) and BPD severity (no BPD/1 or BPD 2–3). Nutritional intake, feeding tolerance, fortification timing and growth were analysed. Results Of 158 infants, 88 (56%) received > 50% MOM and 70 (44%) > 50% PDM. BPD 2–3 occurred in 27 (17.1%) infants with no significant group difference (19% vs. 14%, p = 0.41). Feeding intolerance (44% vs. 11%, p < 0.01), delayed fortification (12.5 vs. 7.0 days, p < 0.01), and later enteral feeding (12.0 vs. 6.0 days, p < 0.01) were associated with BPD 2–3. Conclusion No significant difference in BPD 2–3 incidence was found between MOM and PDM groups. Feeding intolerance, delayed fortification, and slower enteral transition were independent risk factors for grade 2–3 BPD.