Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Eduardo Villamor-Martínez
,
Maria Pierro
ORCID logo ,
Giacomo Cavallaro
ORCID logo ,
Fabio Mosca
,
Boris W. Kramer
,
Eduardo Villamor
* ORCID logo
Version 1 : Received: 11 January 2018 / Approved: 12 January 2018 / Online: 12 January 2018 (05:42:06 CET)

A peer-reviewed article of this Preprint also exists.

Villamor-Martínez, E.; Pierro, M.; Cavallaro, G.; Mosca, F.; Kramer, B.W.; Villamor, E. Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis. Nutrients 2018, 10, 238. Villamor-Martínez, E.; Pierro, M.; Cavallaro, G.; Mosca, F.; Kramer, B.W.; Villamor, E. Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis. Nutrients 2018, 10, 238.

Abstract

Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if mother’s own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCT’s could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (3 studies, risk ratio [RR] 0.89, 95% confidence interval [CI] 0.60–1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (3 studies, RR 0.80, 95% CI 0.68–0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (2 studies, RR 0.77, 95% CI 0.62–0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants, but pasteurization of human milk reduces the benefit.

Keywords

donor human milk; bronchopulmonary dysplasia; breast milk; preterm formula; pasteurization

Subject

Medicine and Pharmacology, Pediatrics, Perinatology and Child Health

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Comments (2)

Comment 1
Received: 16 January 2018
Commenter: Renato S Procianoy
The commenter has declared there is no conflict of interests.
Comment: Please, what do you think about take in consideration the following article:

Fonseca LT, Senna DC, Silveira RC, Procianoy RS.Association between Breast Milk and Bronchopulmonary Dysplasia: A Single Center Observational Study.Am J Perinatol. 2017 Feb;34(3):264-269. doi: 10.1055/s-0036-1586503. Epub 2016 Aug 3.
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Response 1 to Comment 1
Received: 17 January 2018
Commenter:
Eduardo Villamor-Martinez

The commenter has declared there is no conflict of interests.
Comment: Dear Dr. Procianoy,

Thank you very much for your interest in our article and for your comment.

We considered the article you reference for inclusion, but because it did not include a group of infants who received donor human milk, it was excluded. As you mention in the article, "infants did not receive human milk from milk banks during the study period".

We are currently working on another systematic review and meta-analysis of mother's own milk and bronchopulmonary dysplasia, and we have included it in that review.

Best wishes,
Eduardo Villamor-Martinez.

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