Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Mother’s own milk and bronchopulmonary dysplasia in appropriate for gestational age preterm infants

European Journal of Clinical Nutrition volume 78, pages 703–708 (2024)Cite this article

Subjects

Abstract

Objective

To evaluate the association between mother’s own milk (MOM) and bronchopulmonary dysplasia (BPD) in appropriate for gestational age (AGA) preterm infants <32 weeks.

Methods

Clinical data of AGA preterm infants (24+0/7–31+6/7 weeks) were reviewed. Infants with ≥66% of cumulative prescribed enteral volumes as MOM from birth to 36 weeks were allocated to the high provision of MOM group (H-MOM), whereas those with <66% were assigned to the low provision of MOM group (L-MOM). Multiple regressions were used to assess the association of H-MOM with BPD and oxygen saturation to fraction inspired oxygen ratio (SFR) at 36 weeks.

Results

A total of 1041 infants met the inclusion criteria, with a median provision of cumulative enteral nutrition volumes of 5721 (IQR 2616) mL/kg. Among them, 517 (49.7%) were H-MOM and 524 (50.3%) L-MOM infants. H-MOM showed a reduction in the incidence of BPD to 31.6% compared to L-MOM infants. H-MOM had a lower risk of BPD than L-MOM infants after the adjustment for gestational age, sex, cesarean section, mean SFR at the first hours of life, surfactant administration, patent ductus arteriosus, sepsis, prolonged ventilatory supports/oxygen exposure, and cumulative energy intakes from birth to 36 weeks [aOR: 0.613, p = 0.047]. H-MOM was also associated with a lower risk of SFR in the first quartile at 36 weeks [aOR: 0.616, p = 0.028] than L-MOM.

Conclusion

A high provision (≥66%) of enteral volume as MOM from birth to 36 weeks is associated with a reduced risk of both BPD and low SFR at 36 weeks in AGA preterm infants <32 weeks.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Flow diagram of the patients included in the study.

Similar content being viewed by others

Data availability

Data are available on request due to privacy restrictions.

References

  1. Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA. 2015;314:1039–51. https://doi.org/10.1001/jama.2015.10244.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Misund AR, Nerdrum P, Diseth TH. Mental health in women experiencing preterm birth. BMC Pregnancy Childbirth. 2014;14:263. https://doi.org/10.1186/1471-2393-14-263.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Vederhus BJ, Markestad T, Eide GE, Graue M, Halvorsen T. Health related quality of life after extremely preterm birth: a matched controlled cohort study. Health Qual Life outcomes. 2010;8:53. https://doi.org/10.1186/1477-7525-8-53.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Kalikkot Thekkeveedu R, Guaman MC, Shivanna B. Bronchopulmonary dysplasia: a review of pathogenesis and pathophysiology. Respiratory Med. 2017;132:170–7. https://doi.org/10.1016/j.rmed.2017.10.014.

    Article  Google Scholar 

  5. Trittmann JK, Nelin LD, Klebanoff MA. Bronchopulmonary dysplasia and neurodevelopmental outcome in extremely preterm neonates. Eur J Pediatr. 2013;172:1173–80. https://doi.org/10.1007/s00431-013-2016-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Patel AL, Johnson TJ, Robin B, Bigger HR, Buchanan A, Christian E, et al. Influence of own mother’s milk on bronchopulmonary dysplasia and costs. Arch Dis Child Fetal Neonatal Ed. 2017;102:F256–f261. https://doi.org/10.1136/archdischild-2016-310898.

    Article  PubMed  Google Scholar 

  7. Zhu Y, Chen X, Zhu J, Jiang C, Yu Z, Su A. Effect of first mother’s own milk feeding time on the risk of moderate and severe bronchopulmonary dysplasia in infants with very low birth weight. Front Pediatr. 2022;10:887028 https://doi.org/10.3389/fped.2022.887028.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Villamor-Martínez E, Pierro M, Cavallaro G, Mosca F, Villamor E. Mother’s own milk and bronchopulmonary dysplasia: a systematic review and meta-analysis. Front Pediatr. 2019;7:224 https://doi.org/10.3389/fped.2019.00224.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Lund AM, Domellöf M, Pivodic A, Hellström A, Stoltz Sjöström E, Hansen-Pupp I. Mother’s own milk and its relationship to growth and morbidity in a population-based cohort of extremely preterm infants. J Pediatr Gastroenterol Nutr. 2022;74:292–300. https://doi.org/10.1097/mpg.0000000000003352

    Article  CAS  PubMed  Google Scholar 

  10. Miller J, Tonkin E, Damarell RA, McPhee AJ, Suganuma M, Suganuma H et al. A systematic review and meta-analysis of human milk feeding and morbidity in very low birth weight infants. Nutrients. 2018; 10; https://doi.org/10.3390/nu10060707

  11. van Beek PE, Groenendaal F, Broeders L, Dijk PH, Dijkman KP, van den Dungen FAM, et al. Survival and causes of death in extremely preterm infants in the Netherlands. Arch Dis Child Fetal Neonatal Ed. 2021;106:251–7. https://doi.org/10.1136/archdischild-2020-318978.

    Article  PubMed  Google Scholar 

  12. Gortner L, Reiss I. Inhaled nitric oxide for premature babies. Lancet. 2010;376:1985 https://doi.org/10.1016/s0140-6736(10)62257-x.

    Article  CAS  PubMed  Google Scholar 

  13. Bertino E, Spada E, Occhi L, Coscia A, Giuliani F, Gagliardi L, et al. Neonatal anthropometric charts: the Italian neonatal study compared with other European studies. J Pediatr Gastroenterol Nutr. 2010;51:353–61. https://doi.org/10.1097/MPG.0b013e3181da213e

    Article  PubMed  Google Scholar 

  14. Stoll BJ, Hansen N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA, et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110:285–91. https://doi.org/10.1542/peds.110.2.285

    Article  PubMed  Google Scholar 

  15. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg. 1978;187:1–7. https://doi.org/10.1097/00000658-197801000-00001

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Walsh MC, Yao Q, Gettner P, Hale E, Collins M, Hensman A, et al. Impact of a physiologic definition on bronchopulmonary dysplasia rates. Pediatrics. 2004;114:1305–11. https://doi.org/10.1542/peds.2004-0204

    Article  PubMed  Google Scholar 

  17. Xu Y, Yu Z, Li Q, Zhou J, Yin X, Ma Y, et al. Dose-dependent effect of human milk on Bronchopulmonary dysplasia in very low birth weight infants. BMC Pediatr. 2020;20:522 https://doi.org/10.1186/s12887-020-02394-1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Baraldi E, Filippone M. Chronic lung disease after premature birth. N Engl J Med. 2007;357:1946–55. https://doi.org/10.1056/NEJMra067279

    Article  CAS  PubMed  Google Scholar 

  19. Soto-Ramírez N, Alexander M, Karmaus W, Yousefi M, Zhang H, Kurukulaaratchy RJ, et al. Breastfeeding is associated with increased lung function at 18 years of age: a cohort study. Eur Respiratory J. 2012;39:985–91. https://doi.org/10.1183/09031936.00037011.

    Article  Google Scholar 

  20. Beretta F, Lavizzari A, Pesenti N, Arkhangelskaia T, Ciuffini F, Ophorst M, et al. Effect of human milk and other neonatal variables on lung function at three months corrected age. Pediatr Pulmonol. 2021;56:3832–8. https://doi.org/10.1002/ppul.25625.

    Article  PubMed  Google Scholar 

  21. Alzaree FA, AbuShady MM, Atti MA, Fathy GA, Galal EM, Ali A, et al. Effect of early breast milk nutrition on serum insulin-like growth factor-1 in preterm infants. Open Access Macedonian J Med Sci. 2019;7:77–81. https://doi.org/10.3889/oamjms.2019.035.

    Article  Google Scholar 

  22. Ledo A, Arduini A, Asensi MA, Sastre J, Escrig R, Brugada M, et al. Human milk enhances antioxidant defenses against hydroxyl radical aggression in preterm infants. Am J Clin Nutr. 2009;89:210–5. https://doi.org/10.3945/ajcn.2008.26845.

    Article  CAS  PubMed  Google Scholar 

  23. Capasso L, Vento G, Loddo C, Tirone C, Iavarone F, Raimondi F, et al. Oxidative stress and bronchopulmonary dysplasia: evidences from microbiomics, metabolomics, and proteomics. Front Pediatr. 2019;7:30 https://doi.org/10.3389/fped.2019.00030.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Gila-Diaz A, Arribas SM, Algara A, Martín-Cabrejas MA, López de Pablo ÁL, Sáenz de Pipaón M et al. A review of bioactive factors in human breastmilk: a focus on prematurity. Nutrients. 2019; 11. https://doi.org/10.3390/nu11061307.

  25. Jadcherla SR, Gupta A, Fernandez S, Nelin LD, Castile R, Gest AL, et al. Spatiotemporal characteristics of acid refluxate and relationship to symptoms in premature and term infants with chronic lung disease. Am J Gastroenterol. 2008;103:720–8. https://doi.org/10.1111/j.1572-0241.2007.01748.x.

    Article  PubMed  Google Scholar 

  26. Jung E, Lee BS. Late-onset sepsis as a risk factor for bronchopulmonary dysplasia in extremely low birth weight infants: a nationwide cohort study. Sci Rep. 2019;9:15448. https://doi.org/10.1038/s41598-019-51617-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Zhang J, Mu K, Wei L, Fan C, Zhang R, Wang L. A prediction nomogram for moderate-to-severe bronchopulmonary dysplasia in preterm infants < 32 weeks of gestation: a multicenter retrospective study. Front Pediatr. 2023;11:1102878 https://doi.org/10.3389/fped.2023.1102878.

    Article  PubMed  PubMed Central  Google Scholar 

  28. De Paepe ME, Friedman RM, Gundogan F, Pinar H. Postmortem lung weight/body weight standards for term and preterm infants. Pediatr Pulmonol. 2005;40:445–8. https://doi.org/10.1002/ppul.20218

    Article  PubMed  Google Scholar 

  29. Herrmann K, Carroll K. An exclusively human milk diet reduces necrotizing enterocolitis. Breastfeed Med. 2014;9:184–90. https://doi.org/10.1089/bfm.2013.0121.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Strobel NA, Adams C, McAullay DR, Edmond KM. Mother’s own milk compared with formula milk for feeding preterm or low birth weight infants: systematic review and meta-analysis. Pediatrics. 2022; 150. https://doi.org/10.1542/peds.2022-057092D

  31. Spiegler J, Preuß M, Gebauer C, Bendiks M, Herting E, Göpel W. Does breastmilk influence the development of bronchopulmonary dysplasia? J Pediatr. 2016;169:76–80. https://doi.org/10.1016/j.jpeds.2015.10.080.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful to the NICU staff and the Marche Neonatal Network for the support provided (M. Caferri, Fermo Hospital, Fermo, Italy; A. Carlucci, G. Zorzi Ascoli Piceno Hospital, Ascoli Piceno, Italy; N. Guastaferro, San Benedetto del Tronto Hospital, Italy; F. P. Perri, L.Tubaldi Macerata Hospital, Italy; G. Carotti, Jesi Hospital, Italy; L. Migliozzi, Senigallia Hospital, Italy; G. Pennoni, Fabriano Hospital, Italy; G. Franchi, Fano Hospital, Italy; N. Filomeni, Urbino Hospital, Italy; L. Felici, M. Massagli, San Salvatore Hospital Pesaro, Italy). We thank interactive.com for the continuous support of the regional perinatal software Neotools®. The authors also thank Anthony DeMatteo for the language revision.

Author information

Authors and Affiliations

  1. Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy

    Alessio Correani, Lucia Lanciotti, Luca Antognoli & Virgilio Carnielli

  2. Division of Neonatology, Mother and Child Department, G. Salesi Children’s Hospital, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy

    Cristina Spagnoli, Chiara Monachesi, Flavia De Angelis, Chiara Biagetti, Ilaria Burattini & Virgilio Carnielli

Authors
  1. Alessio Correani
    View author publications

    Search author on:PubMed Google Scholar

  2. Cristina Spagnoli
    View author publications

    Search author on:PubMed Google Scholar

  3. Lucia Lanciotti
    View author publications

    Search author on:PubMed Google Scholar

  4. Chiara Monachesi
    View author publications

    Search author on:PubMed Google Scholar

  5. Luca Antognoli
    View author publications

    Search author on:PubMed Google Scholar

  6. Flavia De Angelis
    View author publications

    Search author on:PubMed Google Scholar

  7. Chiara Biagetti
    View author publications

    Search author on:PubMed Google Scholar

  8. Ilaria Burattini
    View author publications

    Search author on:PubMed Google Scholar

  9. Virgilio Carnielli
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Prof. Virgilio Carnielli and Dr. Alessio Correani conceptualized and designed the study, drafted the initial manuscript, and critically reviewed and revised the manuscript. Dr. Cristina Spagnoli, Dr Lucia Lanciotti, Dr Flavia De Angelis, Dr Chiara Biagetti and Dr Ilaria Burattini collected data, carried out the initial analyses, and critically reviewed and revised the manuscript. Dr Chiara Monachesi and Dr Luca Antognoli were in charge of the statistical analysis. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Alessio Correani.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

The local ethics committee, Comitato Etico Regionale delle Marche, authorised the study (Prot. n. 213-18/931) and advised that informed consent from patients was not required due to the retrospective nature of the analysis.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Correani, A., Spagnoli, C., Lanciotti, L. et al. Mother’s own milk and bronchopulmonary dysplasia in appropriate for gestational age preterm infants. Eur J Clin Nutr 78, 703–708 (2024). https://doi.org/10.1038/s41430-024-01455-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41430-024-01455-3

This article is cited by

Search

Advanced search

Quick links