Abstract
BackgroundMost premature and very low birthweight infants cannot tolerate breast milk feeding in the first few days of life and are deprived of its benefits. This study evaluates the clinical outcomes of administering breast milk cell fractions to neonates with a birthweight of ≤1800 g.MethodsWe conducted a randomized controlled trial on 156 infants in the neonatal intensive care unit of Mahdieh Maternity Hospital in Tehran, Iran, from May 2019 to April 2020. All neonates with a birthweight ≤1800 g were enrolled and divided into intervention and control groups using stratified block randomization. Neonates in the intervention group received the extracted breast milk cell fractions (BMCFs) of their own mother’s milk after being centrifuged in the first 6 to 12 h after birth. The control group received routine care, and breastfeeding was started as soon as tolerated in both groups. Study outcomes were necrotizing enterocolitis (NEC), death, and in-hospital complications.ResultsWe divided participants into two groups: 75 neonates in the intervention group and 81 neonates in the control group. The mean birthweight of neonates was 1390.1 ± 314.4 g, and 19 (12.2%) neonates deceased during their in-hospital stay. The incidence of NEC was similar in both groups. After adjustment for possible confounders in the multivariable model, receiving BMCFs were independently associated with lower in-hospital mortality (5 [26.3%] vs. 70 (51.1%]; odds ratio (OR): 0.24; 95% confidence interval [CI] 0.07, 0.86). Also, in a subgroup analysis of neonates with birthweight less than 1500 g, in-hospital mortality was significantly lower in the intervention group (4 [9.5%] vs. 13 [30.2%]; OR: 0.24; 95% CI 0.07, 0.82). There were no differences in major complications such as bronchopulmonary dysplasia and retinopathy of prematurity between the two groups. No adverse effects occurred.ConclusionsOur research demonstrated a significantly lower mortality rate in neonates (with a birthweight of ≤1800 g) who received breast milk cell fractions on the first day of life. Since this is a novel method with minimal intervention, we are looking forward to developing and evaluating this method in larger studies.Trial registrationIIranian Registry of Clinical Trials. Registered 25 May 2019, IRCT20190228042868N1.
Highlights
Most premature and very low birthweight infants cannot tolerate breast milk feeding in the first few days of life and are deprived of its benefits
Breast milk prevents diseases related to free oxygen radicals due to its potent antioxidant property; some examples are necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD) [7,8,9]
0.1–0.2 ml of the lower semi-solid part and cream-colored strings at the bottom of the tube were dropped in the oral cavity of the neonates who participated in the intervention group during the first 6–12 h after birth
Summary
Most premature and very low birthweight infants cannot tolerate breast milk feeding in the first few days of life and are deprived of its benefits. This study evaluates the clinical outcomes of administering breast milk cell fractions to neonates with a birthweight of ≤1800 g. Breast milk is the best source of nutrition for all babies, including premature infants. It plays a notable and sensitive role in improving the function of the immune system [1]. It contains lipids, proteins, carbohydrates, and bioactive molecules, such as vitamins, immunomodulatory factors, and several different types of mediators [2, 3]. Breast milk prevents diseases related to free oxygen radicals due to its potent antioxidant property; some examples are necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD) [7,8,9]
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