Protective role of human milk for preemies unclear

Currently available research findings do not provide conclusive evidence that feeding very low birth weight (VLBW) premature babies human milk offers significant protection against infection.

The belief that human milk feeding will help ward of infection in these vulnerable infants is one of the chief reasons for advocating the practice, clinicians from the UK note in the Archives of Diseases of Childhood Neonatal Edition.

"However, using human milk to feed premature babies is much more difficult than using a formula, so this practice needs to be evidence based," Dr. S. Andrew Spencer from University Hospital of North Staffordshire, told Reuters Health.

To investigate, he and his associates conducted a review of "all publications concerned with human milk feeding and infection in VLBW preterm infants." They identified nine studies that met the strict predefined inclusion criteria.

"We did not find good evidence that human milk protects against infection in preterm infants," Spencer said. "However, this does not mean that it does not," he added.

All of the studies reviewed contained "serious" flaws, including poor study design, inadequate sample size, and failure to account for variables that could influence the outcome, the investigators report.

In addition, most of the studies were performed in developing countries where the infection risk is markedly different from that in developed countries. The studies were also conducted at a time when preterm infant formula was not developed and lacked essential nutrients specifically designed for preterm infants.

"High-quality research on the benefits of using human milk in preterm infants is needed so that we can determine the best way of feeding these tiny vulnerable babies," Spencer told Reuters Health. "Such research will require cooperation between units because most of the studies in the past have included too few babies."

SOURCE: Archives of Diseases of Childhood Fetal Neonatal Edition, November 2004.