How Human Milk Improves Outcomes

June 2015

In the neonatal intensive care unit, the needs for protective benefits of human milk is perhaps more evident than anywhere else. Human milk is considered to be a crucial medication to protect premature infants from serious complications and to help them grow.

The Cost of Prematurity: More Than $26 Billion Annually

Higher doses of human milk can help NICU professionals achieve better outcomes for their vulnerable patients. Research shows a clear dose-response effect between the dose of human milk and a reduction in risk for several disabling morbidities. This reduction in risk potentially translates into lower health care costs. When it comes to getting human milk to your patients, every drop counts.

Better Health Outcomes

In the NICU, the need for the protective benefits of human milk is clear. Consider these important benefits of human milk for at-risk infants:

Colostrum Provides Greater Protection

Preterm colostrum is unique. It has higher concentrations of protein, anti-infectives, anti-inflammatories, growth factors and other protective substances than term colostrum or mature preterm milk.1-10

Protective Bacteria are Passed Directly to the Infant

Human milk feedings yield a greater concentration of protective bacteria in the infant’s intestinal tract than commercial formula. Studies show that protective bacteria from the mother’s gastrointestinal tract “translocate” to her breast milk where they are passed directly to the infant.11-17

chart- composition term and preterm human milk

Improve Outcomes

Higher Suppression of Inflammatory Process in the Intestinal Tract

Protective bacteria, along with other human milk components, help suppress inflammatory processes that originate in the infant’s intestinal tract. Inflammation can act locally and predispose the infant to necrotizing enterocolitis (NEC). Inflammation can also spread to distal organs, increasing the risk of chronic lung disease (CLD), retinopathy of prematurity (ROP) and adverse neurodevelopmental outcomes.11-17

Better Neurodevelopmental Outcomes and Reduced Risk of Rehospitalization

Higher amounts of human milk over the NICU stay are linked to better neurodevelopmental outcomes and a lower risk of rehospitalization in extremely low birth weight (ELBW; < 1000g) infants at 18 and 30 months of corrected age in a dose-response manner.18-20

Lower Risks of NEC, Late Onset Sepsis, and Enteral Feed Intolerance

Other studies suggest that higher amounts of human milk during the early NICU stay lower the risks for NEC, late onset sepsis and enteral feed intolerance in a dose-response manner.21-26

Late onset sepsis costs NICU

The Medela Mother’s Milk Support System

The Medela Mother’s Milk Support System helps you deliver more milk to your vulnerable patients every step of the way. Our system will help you:

  • improve outcomes
  • reduce costs
  • improve patient satisfaction

Medela is committed to human milk science, education, product quality and safety, as well as technological advancement to increase the use of human milk in NICUs and hospitals worldwide. This commitment has led us to develop the industry’s most comprehensive human milk delivery system, which includes milk collection, storage, and delivery options, including transitional feeding and enteral feeding.

 

Learn more about Medela’s Neonatal Solutions for human milk delivery, including the Medela Enteral Feeding Pump, Milk Warming and Enteral Feeding Solutions for the NICU: click here

Learn more about Medela professional breastfeeding solutions: click here

 

References:

  1. Mathur NB, Swarkadas AM, Sharma VK, et al. Antiinfective factors in preterm human colostrum. Acta Pediatria Scandinavia 79: 1039-1044, 1990.
  2. Dvorak B, Fituch CC, Williams CS, Hurst NM, Schanler RJ. Increased epidermal growth factor levels in human milk of mothers with extremely premature infants. Pediatr Res 54: 15-19, 2003.
  3. Magne F, Abely M, Boyer F, Morville P, Pchart P, Suau A. Low species diversity and high interindividual variability in faeces of preterm infants as revealed by sequences of 16S rRNA genes and PCR-temporal temperature gradient gel electrophoresis profiles. FEMS Microbiol Ecol 56: 128-138, 2006.
  4. Rodriguez NR, Meier PP, Groer MW, Zeller JM. Oropharyngeal administration of colostrum to extremely low birthweight infants: Theoretical perspectives. J Perinatol: 1-7, 2008.
  5. Rodriguez N, Miracle DJ, Meier PP. Sharing the science on human milk with mothers of very low birthweight infants. JOGNN 34: 109-119, 2005.
  6. Kunz C, Rudloff S, Baie4 W, Klein N, Strobel S. Oligosaccharides in human milk: Structural, functional, and metabolic aspects. Annu Rev Nutr 20: 699-722, 2000.
  7. Kunz C, Rudloff S, Schad W, Braun D. Lactose derived oligosaccharides in the milk of elephants: comparison with human milk. Br J Nutr 82: 391-399, 1999.
  8. Davidson B, Meinzen-Derr JK, Wagner CL, Newburg DS, Morrow AL. Fucosylated oligosaccharides in human milk in relation to gestational age and stage of lactation. Adv Exp Med Biol 554: 427-30, 2004.
  9. Brand Miller JC, McVeah P. Human milk oligosaccharides: 130 reasons to breastfeed. Br J Nutr 82: 333-335, 1999.
  10. Buescher ES, McWilliams-Koeppen P. Soluble tumor necrosis factor-alpha (TNF-alpha) receptors in human colostrum and milk bind to TNF-alpha and neutralize TNF-alpha bioactivity. Pediatr Res 44: 37-42, 1998.
  11. Caicedo RA, Schanler RJ, Li N, Neu J. The developing intestinal ecosystem: Implications for the neonate. Pediatr Res 58 (4): 625-628, 2005.
  12. Claud EC, Walker WA. Bacterial colonization, probiotics and necrotizing enterocolitis. J Clin Gastroenterol 42: S46-S52, 2008.
  13. Claud EC, Walker WA. Hypothesis: inappropriate colonization of the premature intestine can cause neonatal necrotizing enterocolitis. FASEB J 15 (8): 1398-403, 2001.
  14. Minekawa R, Takeda T, Sakata M, Hayashi M, Isobe A, Yamamoto T, Tasaka K, Murata Y. Human breast milk suppresses the transcriptional regulation of IL-1ß-induced NF-kB signaling in human intestinal cells. Am J Physiol Cell Physiol 287: C1404-C1411, 2004.
  15. Perez PF, Dore J, Leclerc M, Levenez F, Benyacoub J, Serrant P, Segura-Roggero I, et al. Bacterial imprinting of the neonatal immune system: Lessons from maternal cells. Pediatrics 119: 3724-E732, 2007.
  16. Labeta MO, Vidal K, Nores JER, Arias M, Vita N, Morgan BP, Guillemot JC, et al. Innate recognition of bacteria in human milk is mediated by a milk-derived highly expressed pattern recognition receptor, Soluble CD14. J Exp Med 191: 1807-1812, 2000.
  17. Mackie RI, Sghir A, Gaskins HR. Developmental microbial ecology of the neonatal gastrointestinal tract. Am J Clin Nutr 69S: 1035S-1045S, 1999.
  18. Furman L, Taylor G, Minich N, Hack M. The effect of maternal milk on neonatal morbidity of very low-birthweight infants. Arch Pediatr Adolesc Med 157 (1): 66-71, 2003.
  19. Vohr BR, Poindexter BB, Dusick AM; McKinley LT, Wright LL, Langer JC, Poole WK, and for the NICHD Neonatal Research Network. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birthweight infants at 18 months of age. Pediatrics 118: 115-123, 2006.
  20. Vohr BR, Poindexter BB, Dusick AM; McKinley LT, Higgins RD, Langer JC, Poole WK, and for the NICHD Neonatal Research Network. Persistent beneficial effects of breast milk ingested in the neonatal intensive care unit on outcomes of extremely low birthweight infants at 30 months of age. Pediatrics 120: e953-959, 2007.
  21. Sisk PM, Lovelady CA, Gruber KJ, Dillard RG, O’Shea TM. Early human milk feeding is associated with a lower risk of necrotizingenterocolitis in very low birthweight infants. J Perinatol 162: 428-433, 2007.
  22. Meinzen-Derr J, Poindexter BB and Donovan EF, et al. Human milk and late-onset sepsis in infants 401-1000 grams: A secondary analysis [Abstract]. International Society for Research in Human Milk and Lactation: 12th International Conference,Cambridge, England; Abstract 56, 2004.
  23. Meinzen-Derr J, Poindexter B, Wrage L, Morrow AL, Stoll B, Donovan EF. Role of human milk in extremely low birth weight infants’ risk of necrotizing enterocolitis or death. J Perinatol 29: 57-62, 2009.
  24. Schanler RJ. Feeding strategies for premature infants: Beneficial outcomes of feeding fortified human milk versus preterm formula. Pediatr 103: 1150-157, 1999.
  25. Hylander AM, Strobino DM, Dhanireddy R. Human Milk Feedings and Infection Among Very Low Birth Weight Infants. Pediatrics 102; e38, 1998. Pediatrics 121 (6): 1529-1533, 2007.
  26. Sisk, PM, Lovelady, CA, Gruber KJ, Dillard RG, O’Shea TM. Human Milk Consumption and full enteral feeding among infants who weigh ≤1250 grams. Pediatrics 121 (6): e 1528-1533, 2008.