VLBW: Mothers' Milk Dose Response (2020)

VLBW: Mothers' Milk Dose Response (2020)

• Intervention
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and mortality?

  • Conclusion

    One retrospective cohort study observed that compared to infants who did not receive mothers' milk, those who received >50% of intake from mothers' milk the first and second five days of life had a decreased hazard of necrotizing enterocolitis, sepsis or death by 60 days, and a weaker effect was seen for mothers' milk intake of >0-50%.

     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and mortality?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, Kouwenhoven S, Paap M, van Vliet I, Scheerder I, Muizer Y Helder O, van Goudoever J, Vermeulen M. Intake of own mother's milk during the first days of life is associated with decreased morbidity and mortality in very low birth weight infants during the first 60 days of life. Neonatology 2012; 102:276-81
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and total infections?

  • Conclusion

    One retrospective cohort study observed there was no dose-response relationship between quantity of breast milk (100%, 80% to 99%, 20% to 79%, less than 20%, no MOM) and risk of infection after a mean of 70 to 75 days of hospitalization, though type of formula was not specified.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and total infections?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Hylander M, Strobino D, Dhanireddy R. Human milk feedings and infection among very low birth weight infants. Pediatrics 1998; 102:E38
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and retinopathy of prematurity?

  • Conclusion

    There was no dose-response relationship between mother's milk intake during hospitalization and incidence of retinopathy of prematurity at up to 30 months.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and retinopathy of prematurity?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birth-weight infants. Archives of Pediatrics and Adolescent Medicine 2003; 157:66-71
      • Heller C, O'Shea M, Yao Q, Langer J, Ehrenkranz R, Phelps D, Poole W, Stoll B, Duara S, Oh W, Lemons J, Poindexter B. Human milk intake and retinopathy of prematurity in extremely low birth weight infants. Pediatrics 2007; 120:1-9
      • Hylander M, Strobino D, Pezzullo J, Dhanireddy R. Association of human milk feedings with a reduction in retinopathy of prematurity among very low birthweight infants. Journal of Perinatology 2001; 21:356-62
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and sepsis?

  • Conclusion

    In very low birth weight (VLBW) infants, there was a negative dose-response relationship between intake of mother's milk and risk of sepsis at four weeks.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and sepsis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birth-weight infants. Archives of Pediatrics and Adolescent Medicine 2003; 157:66-71
      • Patel A, Johnson T, Engstrom J, Fogg L, Jegier B, Bigger H, Meier P. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. Journal of Perinatology 2013; 33:514-9
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and necrotizing enterocolitis?

  • Conclusion

    In one cohort study, there was no significant difference in risk of necrotizing enterocolitis according to proportion of mothers' milk intake after four weeks.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and necrotizing enterocolitis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birth-weight infants. Archives of Pediatrics and Adolescent Medicine 2003; 157:66-71
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and bronchopulmonary dysplasia?

  • Conclusion

    In very low birth weight (VLBW) infant, evidence was mixed regarding the dose-response relationship between mothers' milk intake and risk of bronchopulmonary dysplasia (BPD) at 36 weeks corrected age, with one cohort study concluding no relationship, and one concluding that odds of BPD decreased by approximately 9.5% for each 10% increase in mothers' milk intake.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and bronchopulmonary dysplasia (BPD)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birth-weight infants. Archives of Pediatrics and Adolescent Medicine 2003; 157:66-71
      • Patel A, Johnson T, Robin B, Bigger H, Buchanan A, Christian E, Nandhan V, Shroff A, Schoeny M, Engstrom J, Meier P. Influence of own mother's milk on bronchopulmonary dysplasia and costs. Archives of Disease in Childhood. Fetal and Neonatal Edition 2017; 102:F256-F261
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and anthropometric measurement?

  • Conclusion

    In very low birth weight (VLBW) infants, there was no dose-response relationship demonstrated between mothers' milk intake from four weeks to approximately four months, and weight, height or head circumference up to 30 months corrected age.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose response and anthropometric measurements?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Innis S, Foote K, MacKinnon M, King D. Plasma and red blood cell fatty acids of low-birth-weight infants fed their mother's expressed breast milk or preterm-infant formula. The American Journal of Clinical Nutrition 1990; 51:994-1000
      • Vohr B, Poindexter B, Dusick A, McKinley L, Higgins R, Langer J, Poole W. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007; 120:e953-9
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and neurodevelopment?

  • Conclusion

    In very low birth weight (VLBW) preterm infants, for every 10mL/kg/d increase in dose of mothers' milk intake during the first four weeks to four months of life was associated with improved Bailey development scores at 20-30 months of follow-up.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and neurodevelopment?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Furman L, Wilson-Costello D, Friedman H, Taylor H, Minich N, Hack M. The effect of neonatal maternal milk feeding on the neurodevelopmental outcome of very low birth weight infants. Journal of Developmental and Behavioral Pediatrics 2004; 25:247-53
      • Patra K, Hamilton M, Johnson T, Greene M, Dabrowski E, Meier P, Patel A. NICU Human Milk Dose and 20-Month Neurodevelopmental Outcome in Very Low Birth Weight Infants. Neonatology 2017; 112:330-336
      • Vohr B, Poindexter B, Dusick A, McKinley L, Wright L, Langer J, Poole W. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118:e115-23
      • Vohr B, Poindexter B, Dusick A, McKinley L, Higgins R, Langer J, Poole W. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007; 120:e953-9
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mothers' milk dose response and time to full enteral feeding?

  • Conclusion

    One large prospective cohort study found that, generally, infants with higher intakes of mothers' milk achieved full enteral feeds at younger ages compared to those who received lower amounts of mothers' milk in the first 120 days or until discharge.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the association between mother's milk dose-response and time to full enteral feeding?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Vohr B, Poindexter B, Dusick A, McKinley L, Higgins R, Langer J, Poole W. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birth weight infants at 30 months of age. Pediatrics 2007; 120:e953-9
  • Search Plan and Results: VLBW: Mothers' Milk Dose Response (2019)