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Original article
Influence of own mother's milk on bronchopulmonary dysplasia and costs
  1. Aloka L Patel1,2,
  2. Tricia J Johnson3,
  3. Beverley Robin1,
  4. Harold R Bigger1,
  5. Ashley Buchanan1,
  6. Elizabeth Christian4,
  7. Vikram Nandhan1,
  8. Anita Shroff4,
  9. Michael Schoeny2,
  10. Janet L Engstrom2,
  11. Paula P Meier1,2
  1. 1Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
  2. 2College of Nursing, Rush University Medical Center, Chicago, Illinois, USA
  3. 3Department of Health Systems Management, Rush University Medical Center, Chicago, Illinois, USA
  4. 4Rush University Medical College, Chicago, Illinois, USA
  1. Correspondence to Dr Aloka L Patel, Department of Pediatrics, Rush University Medical Center, 1653 W. Congress Pkwy., Suite 353 Pavilion, Chicago, IL 60612, USA; Aloka_Patel{at}Rush.edu

Abstract

Background Human milk from the infant's mother (own mother's milk; OMM) feedings reduces the risk of several morbidities in very low birthweight (VLBW) infants, but limited data exist regarding its impact on bronchopulmonary dysplasia (BPD).

Objective To prospectively study the impact of OMM received in the neonatal intensive care unit (NICU) on the risk of BPD and associated costs.

Design/methods A 5-year prospective cohort study of the impact of OMM dose on growth, morbidity and NICU costs in VLBW infants. OMM dose was the proportion of enteral intake that consisted of OMM from birth to 36 weeks postmenstrual age (PMA) or discharge, whichever occurred first. BPD was defined as the receipt of oxygen and/or positive pressure ventilation at 36 weeks PMA. NICU costs included hospital and physician costs.

Results The cohort consisted of 254 VLBW infants with mean birth weight 1027±257 g and gestational age 27.8±2.5 weeks. Multivariable logistic regression demonstrated a 9.5% reduction in the odds of BPD for every 10% increase in OMM dose (OR 0.905 (0.824 to 0.995)). After controlling for demographic and clinical factors, BPD was associated with an increase of US$41 929 in NICU costs.

Conclusions Increased dose of OMM feedings from birth to 36 weeks PMA was associated with a reduction in the odds of BPD in VLBW infants. Thus, high-dose OMM feeding may be an inexpensive, effective strategy to help reduce the risk of this costly multifactorial morbidity.

  • Neonatology
  • bronchopulmonary dysplasia
  • human milk
  • premature infant
  • costs

https://doi.org/10.1136/archdischild-2016-310898

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    Footnotes

    • Contributors ALP made substantial contributions to conception and design, acquisition of data, analysis and interpretation of data and drafting the article. TJJ made substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, and drafting and revising the article critically for important intellectual content. BR made substantial contributions to conception and design, acquisition of data, and drafting and revising the article critically for important intellectual content. HRB made substantial contributions to acquisition of data and revising the article critically for important intellectual content. AB, EC, VN and AS made substantial contributions to acquisition of data and revising the article critically for important intellectual content. MS and PPM made substantial contributions to conception and design, analysis and interpretation of data, and revising the article critically for important intellectual content. JLE made substantial contributions to conception and design and revising the article critically for important intellectual content.

    • Funding The study was funded by NIH Grant NR010009. The funding agency had no role in the design, conduct and reporting of the analysis.

    • Competing interests None declared.

    • Ethics approval Rush University Institutional Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The majority of data collected have now been published or submitted for publication. Data are available from PPM subject to discussion about planned use.

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