Effect of Breast Milk Feeding on Retinopathy of Prematurity in Neonates Less than 1800 Grams: A Cohort

Abstract

Introduction: Human milk has many antioxidants like Docosahexaenoic acid (DHA), inositol, and vitamin E that combat oxidative stress deregulating VEGF which is implicated in the pathogenesis of retinopathy of prematurity (ROP). Thus, it is biologically plausible that human milk is protective towards ROP. Aim and objective: The study aimed to find the association between ROP and breast milk feeding. Methodology: The prospective cohort study was carried out for 18 months at the Newborn unit, SJH. In our study, mothers were asked to maintain a feeding diary (type of milk fed) and history was taken from the mother regularly. Each neonate was later assigned a feeding category including exclusively breast milk fed, more than 50% breast milk fed, more than 50% top milk-fed, and exclusively top milk fed. At four weeks of age, all these neonates were called to undergo screening for ROP. In the case of immature retina, neonates were followed up for repeat fundus exams and results were included in the study. Result: A study on 521 neonates between birth weight of 1–1.8 kgs found that predominant breast milk feeding reduces the chance of any stage ROP (needing repeat screening or intervention). The total incidence of any stage ROP in this study was noted to be 16.2% where 4.1% of total neonates from the predominantly breastfed group as compared to 37.8% from the predominantly top-fed group developed any stage ROP. Conclusion: Breast milk feeding has a significant benefit in reducing any stage ROP and ROP needing intervention, thus it has the potential to prevent a significant cause of childhood blindness. What is already known – Breast milk feeding may be protective towards ROP What the study adds – Breast milk feeding is independently protective towards ROP