Drs De Silva, Jones, and Spencer have provided a timely review of issues relating to studies of breast feeding for very low birthweight (VLBW) infants and rates of infection.¹ We would appreciate the opportunity to clarify some points that they have raised with regard to our study.² We believe our results clearly support our conclusion: that intake of more than 50 ml/kg/day maternal milk through week 4 of life decreases the rate of sepsis in VLBW infants.

de Silva et al state that, “… a major flaw noted in all the studies was the lack of a consistent definition of HM fed groups or methods used to quantify HM intake.” We were able to provide a concise definition of maternal milk intake, which was classified by mean ml/kg/day through week 4 of life, and included groups fed 1–24 ml/kg/day, 25–49 ml/kg/day, and ⩾50 ml/kg/day. These groups were compared with a reference group receiving 0 ml/kg/day maternal milk. We also describe the maternal milk intake of our population in two week increments by daily volume, by total …