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Breastmilk for Healthy Development

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Pediatric Nutrition".

Deadline for manuscript submissions: closed (5 March 2025) | Viewed by 27033

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Special Issue Editors

Dr. Monika Zielińska-Pukos

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Guest Editor

Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 02-787 Warsaw, Poland
Interests: maternal nutrition; infant nutrition; breastfeeding; breastmilk composition; infant development; bioactive compounds

Prof. Dr. Jadwiga Hamułka

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Guest Editor

Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 166 Nowoursynowska Street, 02-787 Warsaw, Poland
Interests: nutrition during pregnancy and lactation; children nutrition; dietary habits; nutrition and cognitive functions; infant development; bioactive compounds; dietary supplements; diet-related chronic diseases
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Special Issue Information

Dear Colleagues,

It is well known that breastfeeding supports the optimal growth and development of infants and protects against the development of non-communicable and infectious diseases, overweight, and obesity across the lifespan. Often, those benefits increase with breastfeeding duration and exclusivity, as a consequence of higher exposure to breastmilk which contains all the essential nutrients and a variety of bioactive compounds, including hormones, growth factors, mRNA, and immunoglobins. Moreover, a growing body of evidence shows that breastmilk composition changes dynamically across the lactation period and each infant–mother dyad has a unique breastmilk composition that explains the effects of lactational programming.

We invite publications in the area of Breastmilk for Healthy Development, covering (but not limited to) the following topics:

Breastmilk composition with a special focus on bioactive components.
Factors affecting breastmilk composition, including the influence of expressing, handling, and storing expressed milk.
The role of breastmilk in supporting optimal growth, development, and shaping health across the lifespan.
The interactions between psychosocial, environmental, and dietary factors, as well as breastmilk composition with possible impacts on infant health and development.
The role of breastfeeding and breastmilk composition in shaping dietary habits and preferences.
Results of in vitro and in vivo studies exploring breastmilk components and their physiological function.

This Special Issue aims to welcome original studies, literature reviews, and meta-analyses exploring the composition and biological role of breastmilk.

Dr. Monika Zielińska-Pukos
Prof. Dr. Jadwiga Hamułka
Guest Editors

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Keywords

breastfeeding
lactation
breastmilk composition
determinants of breastmilk composition
maternal nutrition
donor milk
microbiota
nutritional programming
Developmental Origins of Health and Diseases (DOHaD)
growth and body composition
neurodevelopment
preterm infants
dietary habits

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Published Papers (12 papers)

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13 pages, 784 KiB

Open AccessArticle

Pilot Study of Growth Factors in Colostrum: How Delivery Mode and Maternal Health Impact IGF-1, EGF, NGF, and TGF-β Levels in Polish Women

by Paweł Paśko, Jadwiga Kryczyk-Kozioł, Paweł Zagrodzki, Ewelina Prochownik, Martyna Ziomek, Ryszard Lauterbach, Hubert Huras, Magdalena Staśkiewicz and Justyna Dobrowolska-Iwanek

Nutrients 2025, 17(8), 1386; https://doi.org/10.3390/nu17081386 - 20 Apr 2025

Viewed by 144

Abstract

Background: Breast milk is the most important nutrition for newborns. Growth factors such as insulin-like growth factor 1 (IGF-1), epidermal growth factor (EGF), transforming growth factor-β (TGF-β), and nerve growth factor (NGF) are among its components that play pivotal roles in neonatal development, immune system priming, and gastrointestinal maturation. This study examined the effects of gestational diabetes mellitus (GDM), maternal hypothyroidism, and method of delivery on the concentrations of these factors in colostrum collected at three distinct postpartum time points. Methods: A group of 39 women was included, 20 of whom gave birth vaginally, whereas caesarean section was performed in 19 patients. A total of 18 volunteers were diagnosed with GDM, and 17 suffered from hypothyroidism. Colostrum samples were collected from the volunteers in the first 3 days after birth under hospital conditions. Growth factors like IGF-1, EGF, NGF, and TGF-β were measured in the samples using commercial immunoenzymatic assays. Results: No significant differences were observed in the values of these parameters between the groups of women (with GDM or hypothyroidism and healthy, as well as giving birth naturally and by caesarean section). In addition, the growth factors exhibited good stability within the first few postpartum days (CVs for all studied parameters: in the range of 0.7–5.0%). Conclusions: The pregnancy disorders that were properly controlled and treated by specialists appeared not to affect the levels of the analyzed growth factors—just like the type of delivery and the day of colostrum collection. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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14 pages, 1051 KiB

Open AccessArticle

Trend and Burden of Suboptimal Breastfeeding in Children Under Five Years of Age in 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021

by Bengui Jiang, Kelly Lin, Nicholas Buys, Bei Zhang, Yanfei Qi and Jing Sun

Nutrients 2025, 17(7), 1134; https://doi.org/10.3390/nu17071134 - 25 Mar 2025

Viewed by 463

Abstract

Background/Objectives: Breastfeeding is a cost-effective early child health intervention that has been identified as a protective factor against adverse child health outcomes. However, as estimated by previous epidemiological studies, the prevalence of breastfeeding in most countries around the world is below the recommended levels established by the World Health Organization. This study aims to assess the changes in suboptimal breastfeeding mortality, disability-adjusted life years (DALYs), and years lost to disabilities (YLDs) on a global, regional, and national level from 1990 to 2021. Methods: Data regarding suboptimal breastfeeding in children under 5 years of age from 1990 to 2021 were extracted from the Global Health Data Exchange query tool. Data from 204 countries and territories countries were classified into 5 regions based on the sociodemographic index (SDI) and 21 Global Burden of Disease (GBD) regions according to geographical contiguity. The average annual percentage change (AAPC) was calculated to assess changes in the trends of suboptimal breastfeeding DALYs, YLDs, and mortality in the past 30 years. Results: Countries with high–middle (AAPC = −0.94, 95% CI = −0.95 to −0.93) SDI scores had the greatest degree of improvement in both suboptimal breastfeeding mortality from 28,043.47 to 1128.24 and disease burden from 43,202.94 to 4428.47, while countries with high (AAPC = −0.83, 95% CI = −0.86 to −0.81) and low SDI (AAPC = −0.63, 95% CI = −0.71 to −0.55) scores showed the least improvement from 16,775.75 to 5930.56 and 49,522.23 to 32,881.08, respectively. Conclusions: Significant global improvements in suboptimal breastfeeding mortality and morbidity have occurred in the last 30 years. However, the extent of improvement differs significantly across nations, while some countries also showed no improvements or increased suboptimal breastfeeding mortality and disease burden. Nation-specific policies that account for cultural practices and economic conditions are required to target vulnerable mothers that are unable to achieve optimal breastfeeding. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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12 pages, 2640 KiB

Open AccessArticle

Göttingen Minipigs as a Model for Assessing the Impact of Drugs on the Gut and Milk Microbiota—A Preliminary Study

by Silvia Bencivenni, Patrizia Brigidi, Augusta Zannoni, Domenico Ventrella, Alberto Elmi, Maria Laura Bacci, Monica Forni, Federica D’Amico and Silvia Turroni

Nutrients 2024, 16(23), 4060; https://doi.org/10.3390/nu16234060 - 26 Nov 2024

Viewed by 831

Abstract

Background: Early gut microbiota (GM) dysbiosis can affect a child’s health and has been linked to the onset of pathologies later in life. Breast milk is recognized as a major driver of the structure and dynamics of an infant’s GM. In addition to nutritious and prebiotic compounds, milk contains a microbiota that is shaped by several maternal factors, including gut microorganisms and medications. However, the impact of the latter on the milk microbiota is still largely unknown. Here, we investigated the effects of amoxicillin on the milk microbiota and GM of lactating Göttingen Minipigs sows, a promising model for studying medication transfer during lactation. Methods: Three sows were given amoxicillin (7 mg/kg/day) for three weeks starting from the second week after farrowing. Fecal and milk samples were collected before and after treatment and profiled by 16S rRNA amplicon sequencing. Results: Göttingen Minipigs’ milk microbiota showed similarities to that of humans and conventional sows, with minor compositional shifts after treatment. At the genus level, we observed a decrease in Staphylococcus and o_Bacteroidales;Other;Other, and an increasing trend in the abundance of Streptococcus, Stenotrophomonas, f_Rhodobacteraceae;Other, Proteiniclasticum, f_Propionibacteriaceae;Other and Gemella. In contrast, as expected, the GM was strongly affected by amoxicillin, even at the phylum level. Conclusions: In addition to demonstrating the relevance of Göttingen Minipigs as a valid model for studying the impact of medications on maternal milk and GM, our findings suggest that the milk microbiota may be more stable during antibiotic treatment than the GM. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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14 pages, 1193 KiB

Open AccessArticle

Psychosocial Factors Influencing Breastmilk Production in Mothers After Preterm Birth: The Role of Social Support in Early Lactation Success—A Cross-Sectional Study

by Aleksandra Krawczyk, Agnieszka Czerwińska-Osipiak, Anna Weronika Szablewska and Wiktoria Rozmarynowska

Nutrients 2024, 16(22), 3883; https://doi.org/10.3390/nu16223883 - 14 Nov 2024

Viewed by 1277

Abstract

Background: Preterm birth is a major global health issue, associated with increased neonatal morbidity and mortality. Mothers of preterm infants face unique challenges, particularly with regard to lactation, due to the complexities of preterm neonatal care. Social support has been recognized as a factor in promoting successful breastfeeding, especially in vulnerable groups such as mothers of preterm infants. Objective: This study aimed to explore the psychosocial factors influencing breastfeeding in mothers following preterm birth, with a particular focus on the role of social support in early lactation success. Methods: A cross-sectional observational study was conducted between December 2022 and March 2023 at a tertiary referral hospital in Poland. The study included 130 women (71 mothers of preterm infants and 59 mothers of full-term infants) in the early postpartum period. Data were collected through a self-administered questionnaire and the Polish version of the Berlin Social Support Scales (BSSS). Lactation success was assessed based on the mother’s ability to initiate and maintain breastfeeding or expressed milk production. Statistical analyses included Mann–Whitney U tests, Pearson’s Chi-Square, and logistic regression to determine the association between social support and lactation outcomes. Results: The study revealed that mothers of preterm infants exhibited a greater need for social support compared with those who delivered at term. Social support, particularly perceived emotional and practical support, appeared to be significantly associated with successful early lactation. Women who received adequate social support were more likely to initiate breastfeeding early and maintain lactation. Conclusions: Psychosocial factors, particularly social support, play a critical role in the success of lactation among mothers of preterm infants. These findings underscore the need for comprehensive support systems for mothers of preterm infants to promote breastfeeding and improve neonatal health outcomes. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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14 pages, 3416 KiB

Open AccessArticle

Lactoferrin Supplementation during Pregnancy and Lactation Protects Adult Male Rat Offspring from Hypertension Induced by Maternal Adenine Diet

by You-Lin Tain, Chih-Yao Hou, Wei-Ling Chen, Wei-Ting Liao and Chien-Ning Hsu

Nutrients 2024, 16(16), 2607; https://doi.org/10.3390/nu16162607 - 8 Aug 2024

Cited by 2 | Viewed by 1871

Abstract

Lactoferrin, a glycoprotein derived from breastmilk, is recognized for its health benefits in infants and children; however, its protective effects when administered during gestation and lactation against offspring hypertension remain unclear. This study aimed to investigate whether maternal lactoferrin supplementation could prevent hypertension in offspring born to mothers with chronic kidney disease (CKD), with a focus on nitric oxide (NO), renin–angiotensin system (RAS) regulation, and alterations in gut microbiota and short-chain fatty acids (SCFAs). Prior to pregnancy, female rats were subjected to a 0.5% adenine diet for 3 weeks to induce CKD. During pregnancy and lactation, pregnant rats received one of four diets: normal chow, 0.5% adenine diet, 10% lactoferrin diet, or adenine diet supplemented with lactoferrin. Male offspring were euthanized at 12 weeks of age (n = 8 per group). Supplementation with lactoferrin during gestation and lactation prevented hypertension in adult offspring induced by a maternal adenine diet. The maternal adenine diet caused a decrease in the index of NO availability, which was restored by 67% with maternal LF supplementation. Additionally, LF was related to the regulation of the RAS, as evidenced by a reduced renal expression of renin and the angiotensin II type 1 receptor. Combined maternal adenine and LF diets altered beta diversity, shifted the offspring’s gut microbiota, decreased propionate levels, and reduced the renal expression of SCFA receptors. The beneficial effects of lactoferrin are likely mediated through enhanced NO availability, rebalancing the RAS, and alterations in gut microbiota composition and SCFAs. Our findings suggest that maternal lactoferrin supplementation improves hypertension in offspring in a model of adenine-induced CKD, bringing us closer to potentially translating lactoferrin supplementation clinically for children born to mothers with CKD. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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19 pages, 4245 KiB

Open AccessArticle

Analysis of Human Milk Microbiota in Northern Greece by Comparative 16S rRNA Sequencing vs. Local Dairy Animals

by Margaritis Tsifintaris, Michail Sitmalidis, Maria Tokamani, Christina Anastasiadi, Maria Georganta, Ilias Tsochantaridis, Dimitrios Vlachakis, Panagiotis Tsikouras, Nikolaos Nikolettos, George P. Chrousos, Raphael Sandaltzopoulos and Antonis Giannakakis

Nutrients 2024, 16(14), 2175; https://doi.org/10.3390/nu16142175 - 9 Jul 2024

Cited by 1 | Viewed by 2375

Abstract

Milk is a biological fluid with a dynamic composition of micronutrients and bioactive molecules that serves as a vital nutrient source for infants. Milk composition is affected by multiple factors, including genetics, geographical location, environmental conditions, lactation phase, and maternal nutrition, and plays a key role in dictating its microbiome. This study addresses a less-explored aspect, comparing the microbial communities in human breast milk with those in mature milk from species that are used for milk consumption. Since mature animal milk is used as a supplement for both the infant (formula) and the child/adolescent, our main aim was to identify shared microbial communities in colostrum and mature human milk. Using 16S rRNA metagenomic sequencing, we focused on characterizing the milk microbiota in the Northern Greek population by identifying shared microbial communities across samples and comparing the relative abundance of prevalent genera. We analyzed ten human milk samples (from five mothers), with five collected three days postpartum (colostrum) and five collected thirty to forty days postpartum (mature milk) from corresponding mothers. To perform an interspecies comparison of human milk microbiota, we analyzed five goat and five bovine milk samples from a local dairy industry, collected fifty to seventy days after birth. Alpha diversity analysis indicated moderate diversity and stability in bovine milk, high richness in goat milk, and constrained diversity in breast milk. Beta diversity analysis revealed significant distinctions among mammalian species, emphasizing both presence/absence and abundance-based clustering. Despite noticeable differences, shared microbial components underscore fundamental aspects across all mammalian species, highlighting the presence of a core microbiota predominantly comprising the Proteobacteria, Firmicutes, and Actinobacteriota phyla. At the genus level, Acinetobacter, Gemella, and Sphingobium exhibit significant higher abundance in human milk compared to bovine and goat milk, while Pseudomonas and Atopostipes are more prevalent in animal milk. Our comparative analysis revealed differences and commonalities in the microbial communities of various mammalian milks and unraveled the existence of a common fundamental milk core microbiome. We thus revealed both species-specific and conserved microbial communities in human, bovine, and goat milk. The existence of a common core microbiome with conserved differences between colostrum and mature human milk underscores fundamental similarities in the microbiota of milk across mammalian species, which could offer valuable implications for optimizing the nutritional quality and safety of dairy products as well as supplements for infant health. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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Review

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21 pages, 1438 KiB

Open AccessReview

From Mind to Milk: The Influence of Psychological Factors on the Composition of Human Breast Milk

by Krystian Skowron, Igor Lichocki, Filip Godziszewski and Magdalena Orczyk-Pawiłowicz

Nutrients 2025, 17(6), 1093; https://doi.org/10.3390/nu17061093 - 20 Mar 2025

Viewed by 707

Abstract

Background/Objectives: Breast milk is a complex fluid crucial for infant development, nutrition, and immunological and neurodevelopmental support. Recent findings suggest that factors regarding mental health, such as stress, anxiety, and postpartum depression (PPD), may influence the composition of breast milk. This review aims to synthesize current knowledge regarding the relationship between a mother’s mental state and the biochemical profile of human milk, focusing mainly on nutrients, hormones, immune factors, and microbiota. Methods: A systematic literature search was conducted in PubMed and the Web of Science using predefined keywords related to psychological factors and milk composition. Studies involving validated psychological assessment tools and only human subjects were included, in accordance with PRISMA guidelines. Results: Findings indicated that maternal stress and PPD are associated with alterations in breast milk composition. Elevated cortisol and changes in melatonin and prolactin levels have been observed. Immune components, such as secretory immunoglobulin A and transforming growth factor beta 2, exhibit variable responses depending on stress type and duration. Lower concentrations of docosahexaenoic acid and polyunsaturated fatty acid have been observed among mothers diagnosed with depression. Additionally, maternal psychological distress may influence infants’ gut microbiota composition, potentially affecting long-term health outcomes. Conclusions: The maternal psychological state plays an essential role in shaping the composition of human breast milk. Understanding these associations highlights the need for mental health support during the postpartum period to optimize infant development. Future research should focus on the molecular mechanisms underlying these changes and potential interventions to mitigate adverse effects. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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23 pages, 729 KiB

Open AccessReview

Breastfeeding and Future Cardiovascular, Kidney, and Metabolic Health—A Narrative Review

by You-Lin Tain, Ying-Jui Lin and Chien-Ning Hsu

Nutrients 2025, 17(6), 995; https://doi.org/10.3390/nu17060995 - 12 Mar 2025

Viewed by 742

Abstract

The benefits of breastfeeding for both mother and infant are generally recognized; however, the connections between breast milk, lactation, and long-term offspring health and disease remain incompletely understood. Cardiovascular–kidney–metabolic syndrome (CKMS) has become a major global public health challenge. Insufficient breast milk supply, combined with various early-life environmental factors, markedly increases the future risk of CKMS, as highlighted by the developmental origins of health and disease (DOHaD) concept. Given its richness in nutrients and bioactive components essential for infant health, this review focuses on reprogramming strategies involving breast milk to improve offspring’s cardiovascular, kidney, and metabolic health. It also highlights recent experimental advances in understanding the mechanisms driving CKMS programming. Cumulatively, the evidence suggests that lactational impairment heightens the risk of CKMS development. In contrast, early interventions during the lactation period focused on animal models that leverage breast milk components in response to early-life cues show potential in improving cardiovascular, kidney, and metabolic outcomes—an area warranting further investigation and clinical translation. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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37 pages, 2191 KiB

Open AccessReview

Human Breast Milk Exosomes: Affecting Factors, Their Possible Health Outcomes, and Future Directions in Dietetics

by Elif Çelik, Özge Cemali, Teslime Özge Şahin, Gülsüm Deveci, Nihan Çakır Biçer, İbrahim Murat Hirfanoğlu, Duygu Ağagündüz and Ferenc Budán

Nutrients 2024, 16(20), 3519; https://doi.org/10.3390/nu16203519 - 17 Oct 2024

Cited by 6 | Viewed by 3034

Abstract

Background: Human breast milk is a complex biological fluid containing multifaceted biological compounds that boost immune and metabolic system development that support the short- and long-term health of newborns. Recent literature suggests that human breast milk is a substantial source of nutrients, bioactive molecules, and exosomes. Objectives: This review examines the factors influencing exosomes noted in human milk and the impacts of exosomes on infant health. Furthermore, it discusses potential future prospects for exosome research in dietetics. Methods: Through a narrative review of the existing literature, we focused on exosomes in breast milk, exosome components and their potential impact on exosome health. Results: Exosomes are single-membrane extracellular vesicles of endosomal origin, with an approximate radius of 20–200 nm. They are natural messengers that cells secrete to transport a wide range of diverse cargoes, including deoxyribonucleic acid, ribonucleic acid, proteins, and lipids between various cells. Some studies have reported that the components noted in exosomes in human breast milk could be transferred to the infant and cause epigenetic changes. Thus, it can affect gene expression and cellular event regulation in several tissues. Conclusions: In this manner, exosomes are associated with several pathways, including the immune system, oxidative stress, and cell cycle, and they can affect the short- and long-term health of infants. However, there is still much to learn about the functions, effectiveness, and certain impacts on the health of human breast milk exosomes. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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16 pages, 1104 KiB

Open AccessReview

Melatonin in Human Breast Milk and Its Potential Role in Circadian Entrainment: A Nod towards Chrononutrition?

by Silke Häusler, Emma Lanzinger, Elke Sams, Claudius Fazelnia, Kevin Allmer, Christoph Binder, Russel J. Reiter and Thomas K. Felder

Nutrients 2024, 16(10), 1422; https://doi.org/10.3390/nu16101422 - 8 May 2024

Cited by 5 | Viewed by 6332

Abstract

Breastfeeding is the most appropriate source of a newborn’s nutrition; among the plethora of its benefits, its modulation of circadian rhythmicity with melatonin as a potential neuroendocrine transducer has gained increasing interest. Transplacental transfer assures melatonin provision for the fetus, who is devoid of melatonin secretion. Even after birth, the neonatal pineal gland is not able to produce melatonin rhythmically for several months (with an even more prolonged deficiency following preterm birth). In this context, human breast milk constitutes the main natural source of melatonin: diurnal dynamic changes, an acrophase early after midnight, and changes in melatonin concentrations according to gestational age and during the different stages of lactation have been reported. Understudied thus far are the factors impacting on (changes in) melatonin content in human breast milk and their clinical significance in chronobiological adherence in the neonate: maternal as well as environmental aspects have to be investigated in more detail to guide nursing mothers in optimal feeding schedules which probably means a synchronized instead of mistimed feeding practice. This review aims to be thought-provoking regarding the critical role of melatonin in chrononutrition during breastfeeding, highlighting its potential in circadian entrainment and therefore optimizing (neuro)developmental outcomes in the neonatal setting. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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36 pages, 1709 KiB

Open AccessReview

Human Milk Microbiome—A Review of Scientific Reports

by Agnieszka Dombrowska-Pali, Natalia Wiktorczyk-Kapischke, Agnieszka Chrustek, Dorota Olszewska-Słonina, Eugenia Gospodarek-Komkowska and Maciej W. Socha

Nutrients 2024, 16(10), 1420; https://doi.org/10.3390/nu16101420 - 8 May 2024

Cited by 17 | Viewed by 5276

Abstract

One of the most important bioactive components of breast milk are free breast milk oligosaccharides, which are a source of energy for commensal intestinal microorganisms, stimulating the growth of Bifidobacterium, Lactobacillus, and Bacteroides in a child’s digestive tract. There is some evidence that maternal, perinatal, and environmental-cultural factors influence the modulation of the breast milk microbiome. This review summarizes research that has examined the composition of the breast milk microbiome and the factors that may influence it. The manuscript highlights the potential importance of the breast milk microbiome for the future development and health of children. The origin of bacteria in breast milk is thought to include the mother’s digestive tract (entero-mammary tract), bacterial exposure to the breast during breastfeeding, and the retrograde flow of breast milk from the infant’s mouth to the woman’s milk ducts. Unfortunately, despite increasingly more precise methods for assessing microorganisms in human milk, the topic of the human milk microbiome is still quite limited and requires scientific research that takes into account various conditions. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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14 pages, 2151 KiB

Open AccessSystematic Review

Association of Fortification with Human Milk versus Bovine Milk-Based Fortifiers on Short-Term Outcomes in Preterm Infants—A Meta-Analysis

by Radu Galis, Paula Trif, Diana Mudura, Jan Mazela, Mandy C. Daly, Boris W. Kramer and Shivashankar Diggikar

Nutrients 2024, 16(6), 910; https://doi.org/10.3390/nu16060910 - 21 Mar 2024

Cited by 7 | Viewed by 3206

Abstract

This meta-analysis assessed short-term outcomes after using human milk-derived fortifiers (HMFs) compared with bovine milk fortifiers (BMFs) in preterm infants fed an exclusive human milk (HM) diet, either mother’s own milk (MOM) or donor human milk (DHM). We searched PubMed, Embase, Google Scholar, CENTRAL and CINHAL between January 2015 and August 2023 for studies reporting outcomes in infants with ≤28 weeks gestation and/or birthweight ≤ 1500 g on an exclusive human milk diet fortified with HMF versus BMF. The primary outcomes were death and NEC (stage ≥ 2). Four studies with a total of 681 infants were included. Mortality was significantly lower in infants fed with an HM-HMFs diet (four studies, 681 infants; RR = 0.50, 95% CI = 0.26–0.94; p = 0.03; I² = 0%), NEC was similar between the two groups (four studies, 681 infants; RR = 0.48, 95% CI = 0.20–1.17; p = 0.11; I²= 39%). BPD was higher in the HM-BMFs group (four studies, 663 infants; RR = 0.83, 95% CI = 0.69–1.000; p = 0.05, I² = 0%), although not statistically significant. No differences were found for sepsis (RR = 0.97, 95% CI = 0.66–1.42; p = 0.96; I² = 26%) or combined ROP (four studies, 671 infants; RR = 0.64, 95% CI = 0.53–1.07; p = 0.28; I² = 69%). An HM-HMFs diet could possibly be associated with decreased mortality with no association with NEC, BPD, sepsis, or ROP. This meta-analysis was limited by the small number of studies included. However, the results should not be refuted for this reason as they provide an impetus for subsequent clinical trials to assess the observed associations. Full article

(This article belongs to the Special Issue Breastmilk for Healthy Development)

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