Pasteurization of breastmilk decreases the rate of postnatally acquired cytomegalovirus infections, but shows a nonsignificant trend to an increased rate of necrotizing enterocolitis in very preterm infants--a preliminary study

Breastfeed Med. 2015 Mar;10(2):113-7. doi: 10.1089/bfm.2014.0108. Epub 2015 Feb 3.

Abstract

Aim: This study assessed whether feeding preterm infants unpasteurized breastmilk (1) decreases the rate of late-onset sepsis and necrotizing enterocolitis and (2) increases the rate of postnatally acquired cytomegalovirus infections.

Subjects and methods: Between January 2008 and July 2013, preterm infants below 32 completed weeks of gestational age admitted to the neonatal intensive care unit of Innsbruck Medical University (Innsbruck, Austria) (n=344) were eligible for the study. Of those, 323 fed breastmilk were retrospectively enrolled in the study. Two groups were formed, with 164 infants being fed unpasteurized and 159 infants being fed pasteurized breastmilk.

Results: There was no significant difference in the rate of late-onset sepsis or necrotizing enterocolitis between the unpasteurized and pasteurized breastmilk groups (late-onset sepsis, 15.9% versus 15.1% [p=0.486]; necrotizing enterocolitis, 2.4% versus 4.4% [p=0.254]). The number of infants diagnosed with postnatally acquired cytomegalovirus infection was significantly higher in the unpasteurized group (39.3%) compared with the pasteurized group (4.2%) (p=0.008).

Conclusions: Feeding preterm infants unpasteurized breastmilk increases the rate of postnatally acquired cytomegalovirus infections. However, we also demonstrate a nonsignificant trend to a decreased rate of necrotizing enterocolitis in the unpasteurized group, which needs to be confirmed in larger studies.

Publication types

  • Observational Study

MeSH terms

  • Austria / epidemiology
  • Cytomegalovirus Infections / epidemiology
  • Cytomegalovirus Infections / microbiology
  • Cytomegalovirus Infections / prevention & control*
  • Enterocolitis, Necrotizing / epidemiology
  • Enterocolitis, Necrotizing / microbiology
  • Enterocolitis, Necrotizing / prevention & control*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal / standards*
  • Male
  • Milk, Human / immunology
  • Milk, Human / microbiology*
  • Pasteurization* / methods
  • Practice Guidelines as Topic
  • Risk Assessment