Published online July 2, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. 1-9 (doi:10.1542/peds.2006-1465)
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ARTICLE

Human Milk Intake and Retinopathy of Prematurity in Extremely Low Birth Weight Infants

Cherrie D. Heller, MD, MPHa, Michael O'Shea, MD, MPHa, Qing Yao, PhDb, John Langer, MScb, Richard A. Ehrenkranz, MDc, Dale L. Phelps, MDd, W. Kenneth Poole, PhDb, Barbara Stoll, MDe, Shahnaz Duara, MDf, William Oh, MDg, James Lemons, MDh, Brenda Poindexter, MD, MSh for the NICHD Neonatal Research Networki

a Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina
b RTI International, Research Triangle Park, North Carolina
c Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut
d Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
e Department of Pediatrics, Emory School of Medicine, Atlanta, Georgia
f Department of Pediatrics, University of Miami School of Medicine, Miami, Florida
g Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island
h Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
i National Institute of Child Health and Human Development, Rockville, Maryland

OBJECTIVES. Our goal was to analyze the association between human milk intake and severe retinopathy of prematurity in extremely low birth weight infants.

PATIENTS AND METHODS. This study is a secondary analysis of data collected for a trial of glutamine supplementation in extremely low birth weight infants (birth weight <1000 g). Among the 1433 participants in that trial, data are available regarding human milk intake and the occurrence of severe retinopathy of prematurity (defined in this study as retinopathy of prematurity treated surgically) for 1057 infants. The volume of human milk intake was expressed as the mean volume (milliliters per kilogram per day) and the mean proportional volume (proportion of total nutritional intake) from birth to discharge or transfer. Using logistic regression, we estimated odds ratios and 95% confidence intervals for any human milk intake and, among infants who received human milk, for each 10 mL/kg per day and each 10% increase in volume.

RESULTS. Of the 1057 infants included in this cohort, 788 infants (75%) received at least some human milk. Among these milk-fed infants, the median volume of human milk intake was 30 mL/kg per day (interquartile range: 6–83 mL/kg per day), and the median proportional volume of human milk intake was 0.18 (interquartile range: 0.03–0.66). One hundred sixty-three infants (15%) developed severe retinopathy of prematurity.

CONCLUSIONS. In extremely low birth weight infants, human milk intake was not associated with a decreased risk of severe retinopathy of prematurity.

Key Words: human milk • retinopathy of prematurity • premature

Abbreviations: ROP—retinopathy of prematurity • LCPUFA—long-chain polyunsaturated fatty acid • HM—human milk • NICHD—National Institute of Child Health and Human Development • NRN— Neonatal Research Network • MWF—Monday, Wednesday, Friday • FGR—fetal growth ratio • OR—odds ratio • CI—confidence interval • DHA—docosahexaenoic acid

Accepted Mar 15, 2007.




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P. P. Meier and J. L. Engstrom
Evidence-based Practices to Promote Exclusive Feeding of Human Milk in Very Low-birthweight Infants
NeoReviews, November 1, 2007; 8(11): e467 - e477.
[Abstract] [Full Text] [PDF]