Article

Pasteurization of Mother's Own Milk for Preterm Infants Does Not Reduce the Incidence of Late-Onset Sepsis

Neonatal Intensive Care Unit, University Hospitals Leuven, Belgium.
Neonatology (Impact Factor: 2.65). 12/2012; 103(3):169-175. DOI: 10.1159/000345419
Source: PubMed

ABSTRACT

Background: Feeding preterm infants human milk has a beneficial effect on the risk of late-onset sepsis (LOS). Due to lack of microbiological standards, practices such as pasteurization of mother's own milk differ widely among neonatal intensive care units worldwide. Objectives: To investigate whether pasteurization of mother's own milk for very-low-birth-weight (VLBW) infants influences the incidence and severity of infection-related outcomes. Methods: In this randomized controlled trial, preterm infants (gestational age <32 weeks and/or birth weight <1,500 g) received either raw or pasteurized mother's own milk during the first 8 weeks of life. The primary outcome was the incidence of proven LOS. A dose-response relation was verified, i.e. the dependence of the risk of sepsis on the actual and cumulative quantities of mother's own milk. Results: This study included 303 VLBW infants (mean birth weight: 1,276 g; mean gestational age: 29 weeks) whose baseline and nutritional characteristics were similar. The incidence of laboratory-confirmed sepsis was not statistically different in infants fed raw milk compared to infants who received pasteurized milk: 22/151 (0.15, CI: 0.08-0.20) and 31/152 (0.20, CI: 0.14-0.27), respectively (RR: 0.71; 95% CI: 0.43-1.17). A significant dose-response relation was observed between the adjusted quantity of enteral feeding and the risk of LOS, regardless of the type of feeding. Conclusion: For preterm infants, pasteurization of mother's own milk shows a trend towards an increase in infectious morbidity, although no statistical significance was reached. Practices should focus on collection, storage and labeling procedures to ensure the safety and quality of expressed milk.

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Available from: Veerle Cossey, Jun 19, 2014
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    • ". For these neonates, microbiological control of raw milk has also been proposed in the absence of mastitis [37]. However, the best strategy has yet to be developed as it does not appear that pasteurizing maternal milk changes the overall incidence of late onset GBS disease in preterm infants [38]. In a recent review article of cases of late onset GBS disease from breast milk, GBS was found in 0–2% of raw milk samples and 1.4% of pasteurized milk samples [9] "
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