Abstract
Raw breast milk is the optimal nutrition for infants, but it is also the primary cause of acquired cytomegalovirus (CMV) infection. Thus, many countries have chosen to contraindicate to feed raw breast milk preterm infants from CMV-positive mothers before a corrected age of 32 weeks or under a weight of 1500 g. French national recommendations have not been updated since 2005. An audit of the French practices regarding the nutrition with raw breast milk in preterm infants was carried out using a questionnaire sent to all neonatal care units. Diagnosed postnatal milk-acquired CMV infections have been analysed using hospitalisation reports. Seventy-five percent of the neonatal units responded: 24% complied with the French recommendations, 20% contraindicated raw breast milk to all infants before 32 weeks regardless of the mothers’ CMV-status, whereas 25% fed all preterm infants unconditionally with raw breast milk. Thirty-five cases of infants with milk-acquired CMV infections have been reported. The diagnosis was undeniable for five patients. In France, a high heterogeneity marks medical practices concerning the use of raw breast milk and the diagnostic approach for breast milk-acquired CMV infection is often incomplete. In this context, updated national recommendations and monitored CMV infections are urgently needed.
Highlights
In the last fifty years, the development of neonatology reversed the prognosis of preterm infants with a weight over 1500 g from a mortality rate of 85% to a survival rate without sequelae of85% [1,2]
In France, a high heterogeneity marks medical practices concerning the use of raw breast milk and the diagnostic approach for breast milk-acquired CMV infection is often incomplete
It reduces the risk of infection and inflammatory phenomena, leading to a significant decrease in the incidence of bronchopulmonary dysplasia [9], retinopathy of prematurity [10] and necrotising enterocolitis (NEC) [11]
Summary
In the last fifty years, the development of neonatology reversed the prognosis of preterm infants with a weight over 1500 g from a mortality rate of 85% to a survival rate without sequelae of85% [1,2]. In the last fifty years, the development of neonatology reversed the prognosis of preterm infants with a weight over 1500 g from a mortality rate of 85% to a survival rate without sequelae of. Its composition adapts to the gestational age at birth to better protect preterm infants and to regulate their immune response [5,6,7,8]. It reduces the risk of infection and inflammatory phenomena, leading to a significant decrease in the incidence of bronchopulmonary dysplasia [9], retinopathy of prematurity [10] and necrotising enterocolitis (NEC) [11]. Nutritional values of breast milk have a beneficial role in both short and long-term neurological development [12,13,14], and exposure to breast milk antigens promotes the development of tolerance and significantly reduces the risk of allergy and atopic diseases [15,16]
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