The effect of maternal milk on neonatal morbidity of very low-birth-weight infants

Arch Pediatr Adolesc Med. 2003 Jan;157(1):66-71. doi: 10.1001/archpedi.157.1.66.


Objective: To examine the dose effect of maternal milk on neonatal morbidity of very low-birth-weight (<1.5 kg) infants.

Design: Prospective observational study.

Setting: An urban tertiary care neonatal intensive care unit and follow-up clinic.

Population: One hundred nineteen singleton very low-birth-weight infants admitted from January 1, 1997, to February 14, 1999 (mean birth weight, 1056 g; mean gestational age, 28 weeks; 57% male; and 43% white).

Methods: A comparison of the effect on neonatal outcomes of daily graded doses (1-24, 25-49, and > 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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Female
  • Humans
  • Infant Food*
  • Infant Nutritional Physiological Phenomena
  • Infant, Newborn
  • Infant, Newborn, Diseases / epidemiology
  • Infant, Newborn, Diseases / prevention & control*
  • Infant, Very Low Birth Weight
  • Intensive Care Units, Neonatal
  • Male
  • Milk, Human*
  • Poisson Distribution
  • Sepsis / prevention & control