Dose-dependent effect of human milk on Bronchopulmonary dysp
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Human milk has potential protective effects against bronchopulmonary dysplasia (BPD). This study aimed to evaluate the dose-dependent effects of human milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants.

This retrospective cohort study of preterm infants was conducted on preterm infants of gestational age less than 34 weeks and birth weight less than 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement. The multivariate analysis was performed to compare the effect outcomes of daily graded doses of human milk on neonatal outcomes throughout the first 4 weeks of life versus a reference group receiving no human milk. The models were adjusted for potential confounding variables.

Of 964 included infants, 279 received exclusive preterm formula, 128 received 1–24 ml/(kg · day), 139 received 25–49 ml/(kg · day), and 418 received more than 50 ml/(kg · day) human milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of human milk daily had:
- lower incidences of BPD [27.5% in more than 50 mL/(kg · day)
- moderate & severe BPD [8.9% in more than 50 mL/kg · day),
- necrotizing enterocolitis NEC [3.8% in more than 50mL/(kg · day)
- late-onset sepsis [LOS; 9.3% in more than 50mL/(kg · day), - extrauterine growth retardation [EUGR; 38.5% in more than 50mL/(kg · day).

The logistic regression indicated that those receiving more than 50ml/kg · day human milk had lower odds of BPD. A daily threshold amount of more than 50ml/(kg · day) human milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants.