Abstract
Background: Bronchopulmonary dysplasia (BPD) is the most common complication of very preterm birth and can lead to lifelong health consequences. Optimal nutrition is a cornerstone in the prevention and treatment of BPD. In very preterm infants, mother's own milk (MOM) feeding is associated with lower risks of necrotizing enterocolitis, retinopathy of prematurity, and sepsis. Although several studies have shown that MOM may protect against BPD, a systematic analysis of the evidence has not been performed to date.Methods: A comprehensive literature search was conducted using PubMed/MEDLINE and EMBASE, from their inception to 1 December 2017. Longitudinal studies comparing the incidence of BPD in preterm infants fed with exclusive MOM, MOM supplemented with preterm formula (PF), and/or exclusively fed with PF were selected. A random-effects model was used to calculate the Mantel Haenszel risk ratio (RR) and 95% confidence interval (CI).Results: Fifteen studies met the inclusion criteria (4,984 infants, 1,416 BPD cases). Use of exclusive MOM feedings was associated with a significant reduction in the risk of BPD (RR 0.74, 95% CI 0.57–0.96, 5 studies). In contrast, meta-analysis could not demonstrate a significant effect on BPD risk when infants fed with more than 50% MOM were compared with infants fed with <50% MOM (RR 0.98, 95% CI 0.77–1.23, 10 studies) or when infants fed with MOM supplemented with PF were compared with infants fed with exclusive PF (RR 1.00, 95% CI 0.78–1.27, 6 studies). Meta-regression showed that differences in gestational age were a significant confounder of the effect of MOM.Conclusion: To our knowledge, this is the first systematic review and meta-analysis that specifically evaluates the role of MOM on BPD. Our data indicate that MOM may reduce the incidence of BPD when used as an exclusive diet, but this result needs to be interpreted with caution. We did not find the same difference in analyses with other dosages of MOM. Further studies adequately powered to detect changes in BPD rates and that adjust for confounders are needed to confirm the beneficial effects of MOM on BPD.
Highlights
METHODSMother’s own milk (MOM), fresh or frozen, is the normative standard for preterm infant feeding and nutrition [1,2,3,4]
Two very recent systematic reviews confirmed that the protective effects of human milk (i.e., METHODSMother’s own milk (MOM) and/or donor human milk (DHM)) on Bronchopulmonary dysplasia (BPD) are only observed in meta-analysis of observational studies [10, 11]
Our data indicate that MOM may reduce the incidence of BPD when used as an exclusive diet, but this result needs to be interpreted with caution
Summary
METHODSMother’s own milk (MOM), fresh or frozen, is the normative standard for preterm infant feeding and nutrition [1,2,3,4]. Bronchopulmonary dysplasia (BPD) is one of the most common complications of prematurity, and it predicts multiple adverse outcomes including chronic respiratory impairment and neurodevelopmental delay [6, 7]. Optimal nutritional support is considered a cornerstone in the treatment/prevention of BPD [8]. We performed a systematic review and metaanalysis on the effects of DHM on BPD [9]. Meta-analysis of observational studies showed a protective effect of DHM supplementation on BPD [9]. Two very recent systematic reviews confirmed that the protective effects of human milk (i.e., MOM and/or DHM) on BPD are only observed in meta-analysis of observational studies [10, 11]. Several studies have shown that MOM may protect against BPD, a systematic analysis of the evidence has not been performed to date
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
