Impact of early human milk on sepsis and health-care costs in very low birth weight infants

J Perinatol. 2013 Jul;33(7):514-9. doi: 10.1038/jp.2013.2. Epub 2013 Jan 31.


Objective: To study the incidence of sepsis and neonatal intensive care unit (NICU) costs as a function of the human milk (HM) dose received during the first 28 days post birth for very low birth weight (VLBW) infants.

Study design: Prospective cohort study of 175 VLBW infants. The average daily dose of HM (ADDHM) was calculated from daily nutritional data for the first 28 days post birth (ADDHM-Days 1-28). Other covariates associated with sepsis were used to create a propensity score, combining multiple risk factors into a single metric.

Result: The mean gestational age and birth weight were 28.1 ± 2.4 weeks and 1087 ± 252 g, respectively. The mean ADDHM-Days 1-28 was 54 ± 39 ml kg(-1) day(-1) (range 0-135). Binary logistic regression analysis controlling for propensity score revealed that increasing ADDHM-Days 1-28 was associated with lower odds of sepsis (odds ratio 0.981, 95% confidence interval 0.967-0.995, P=0.008). Increasing ADDHM-Days 1-28 was associated with significantly lower NICU costs.

Conclusion: A dose-response relationship was demonstrated between ADDHM-Days 1-28 and a reduction in the odds of sepsis and associated NICU costs after controlling for propensity score. For every HM dose increase of 10 ml kg(-1) day(-1), the odds of sepsis decreased by 19%. NICU costs were lowest in the VLBW infants who received the highest ADDHM-Days 1-28.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cost of Illness
  • Costs and Cost Analysis
  • Feeding Methods
  • Female
  • Gestational Age
  • Health Care Costs
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / economics
  • Infant, Premature, Diseases / prevention & control*
  • Infant, Very Low Birth Weight*
  • Intensive Care Units, Neonatal / economics
  • Male
  • Milk, Human*
  • Propensity Score
  • Prospective Studies
  • Sepsis / economics
  • Sepsis / prevention & control*