Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Eduardo Villamor-Martinez, Maria Pierro, Giacomo Cavallaro, Fabio Mosca, Boris W. Kramer, Eduardo Villamor*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review

64 Citations (Web of Science)

Abstract

Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if the mother's own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCTs could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (three studies, risk ratio (RR) 0.89, 95% confidence interval (CI) 0.60-1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67-0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (three studies, RR 0.80, 95% CI 0.68-0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (two studies, RR 0.77, 95% CI 0.62-0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants.
Original languageEnglish
Article number238
Number of pages16
JournalNutrients
Volume10
Issue number2
DOIs
Publication statusPublished - 20 Feb 2018

Keywords

  • donor human milk
  • bronchopulmonary dysplasia
  • breast milk
  • preterm formula
  • pasteurization
  • BIRTH-WEIGHT INFANTS
  • EXCLUSIVE HUMAN-MILK
  • EXTREMELY PREMATURE-INFANTS
  • RANDOMIZED CLINICAL-TRIAL
  • MOTHERS OWN MILK
  • PRETERM INFANTS
  • NECROTIZING ENTEROCOLITIS
  • CYTOMEGALOVIRUS-INFECTION
  • MATERNAL MILK
  • VLBW INFANTS
  • Infant, Very Low Birth Weight
  • Humans
  • Pasteurization
  • Breast Feeding/adverse effects
  • Protective Factors
  • Breast Milk Expression
  • Bronchopulmonary Dysplasia/diagnosis
  • Female
  • Odds Ratio
  • Infant, Newborn
  • Bottle Feeding/adverse effects
  • Infant Formula
  • Risk Factors
  • Treatment Outcome
  • Gestational Age
  • Pregnancy
  • Birth Weight
  • Milk Ejection
  • Infant, Premature

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