Early Fresh Human Milk and Sepsis in Very Low Birth Weight Infants
Ricardo M. Nieto, Nestor A. Dinerstein, Claudio L. Solana, Daniela Ventura, Miguel A. Larguia, Federic o General. Neonatology, Hospital Sardá, Buenos Aire s, Argentina; Fundación Neonatológica Dr. Miguel Largu ía, Buenos Aires, Argentina; Nutricia Bagó, Buenos Aires, Argentina
Several studies have demonstrated an associa tion between fresh human milk (FHM) feeding and a red uction in the incidence of sepsis in very low birth weight infants (VLBW). The critical period and volume of human milk that should be administered to exert a protective effect are not well defined.
To evaluate the volume of FHM that VLBW sh ould receive during the first week after birth to red uce the risk of lat e onset sepsis (LOS).
All patients included in a RCT design ed to compare morbidity and tolerability in VLBW exclu sively fed with human milk during the first 28 days o f life showed a lower incidence of LOS in those patients who received human milk since the first day of life 1 . An univariate analysis between patients who devel oped or not LOS was performed and those variables with statistical significan ce were included in a multivariate model. The volume of FHM administered during the first week of life w as divided into quartiles and the dose of milk that exerted a protecti ve effect was determined.
Ninety six patients included in our previous study were analyzed. Characteristics of patients with LO S (n=24) that were statistically different compared wi th those without sepsis are shown in the table. To feed with FHM >40 ml/kg in the first of life was the cutoff point t hat was associated with a reduction in the incidence of LO S (ORa 75 % [95%CI 14-93%]). The proportion of patients who sur vived free of LOS until hospital discharge is shown in the figure.
A dose-response relationship was demonstrat ed between FHM in the first week of life and a reduct ion in the odds of sepsis.
E-PAS2013:1541.579. Early Minimal Enteral Feeding W ith Human Milk In Very Low Birth Weight Infants: Whe n To Start?