HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population
Human Milk Feedings and Infection Among Very Low Birth Weight Infants
BACKGROUND Preterm infants are immunologically immature at birth . Previous studies have demonstrated that human milk protects against infection in full-term infants , but there are few studies of its effect for preterm infants . OBJECTIVE To examine the effect of human milk feedings on infection incidence among very low birth weight ( VLBW ) infants during their initial hospitalization . STUDY DESIGN The sample consisted of 212 consecutive VLBW infants admitted to the Georgetown University Medical Center neonatal intensive care unit ( NICU ) during 1992 - 1993 and surviving to receive enteral feeding .  Type of feeding ( human milk vs formula ) , presence of infection and sepsis/meningitis ( clinical signs and positive cultures for pathogenic organisms ) , and potential confounding variables were abstract ed from medical records . Multiple logistic regression was used to control for confounders . RESULTS The incidence of infection ( human milk [ 29.3 % ] vs formula [ 47.2 % ] ) and sepsis/meningitis ( human milk [ 19.5 % ] vs formula [ 32.6 % ] ) differed significantly by type of feeding . Major risk factors for infection were similar in both groups . Human milk feeding was independently correlated with a reduced odds of infection ( odds ratio [ OR ] = 0.43 ; 95 % confidence interval [ CI ] : 0.23 - 0.81 ) , controlling for gestational age , 5-minute Apgar score , mechanical ventilation days , and days without enteral feedings ; and was independently correlated with a reduced odds of sepsis/meningitis ( OR = 0.47 , 95 % CI:0.23 - 0 . 95 ) , controlling for gestational age , mechanical ventilation days , and days without enteral feedings . CONCLUSIONS The incidence of any infection and sepsis/meningitis are significantly reduced in  human milk-fed VLBW infants compared with exclusively formula-fed VLBW infants
HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population