The Effect of Maternal Milk on Neonatal Morbidity of Very Low-Birth-Weight Infants

OBJECTIVE: To examine the dose effect of maternal milk on neonatal morbidity of very low-birth-weight ( or = 50 mL/kg of body weight) of maternal milk through week 4 of life vs a reference group receiving no maternal milk. MAIN OUTCOME MEASURES: Neonatal outcomes examined included rates of sepsis after age 5 days, retinopathy of prematurity, chronic lung disease, necrotizing enterocolitis, jaundice, duration of ventilator dependence, and length of hospital stay. RESULTS: Seventy-nine infants (66%) received maternal milk, of whom 32 received at least 50 mL/kg per day through week 4 of life. Poisson regression analysis adjusting for birth weight, sex, and ethnicity revealed that the mean number of episodes of sepsis for infants receiving at least 50 mL/kg per day was lower by a factor of 0.27 (95% confidence interval, 0.08-0.95) compared with infants receiving no maternal milk. There was no effect of maternal milk on other neonatal outcomes. CONCLUSIONS: A daily threshold amount of at least 50 mL/kg of maternal milk through week 4 of life is needed to decrease the rate of sepsis in very low-birth-weight infants, but maternal milk does not affect other neonatal morbidities.