Newborn screening program for haemoglobinopathies in Haiti

Abstract

ing premature infants born to CMV-seropositive mothers at this moment. To assess the risk of post-natal cytomegalovirus (CMV) transmission to extremely low birth weight (ELBW, birth weight <1000 g) infants fed with their mother's milk fresh for longer than one month. Prospective, observational study including all 63 ELBW infants– mothers admitted in our NICU from April 2005 to August 2010. Infants' urine and their own mother's fresh breast milk were tested for CMV culture once a week until discharge. Clinical course and laboratory findings of CMV infected infants were documented. Forty-one mothers (41/63, 65%) were CMV-seropositive at delivery and 34 of these breastfeeding their 34 infants for longer than 1 month. CMV virolactia was detected in 18/34 (53%) seropositive mothers, and 7/ 18 (39%) ELBW infants fed with CMV-positive milk was found infected during hospital stay. Three out of 7 (43%) ELBW infected infants hadmild sepsis-like clinical manifestations (desaturation spells, bradycardia, increased oxygen requirement, abdominal distension, and poor skin perfusion): these symptoms recovered spontaneously in a short time. Three infants showed neutropenia (N<1100/mmc) that not require treatment with granulokine. All infected infants were <28 weeks gestational age (GA). All clinical infected infants were <26 weeks GA at birth. In our experience CMV infection via mother's fresh milk is mild, self-limiting even in ELBW infants. Thus feeding ELBW infants with their mother's fresh milk is a safe and beneficial option.