[Impact of donor human milk bank on clinical outcomes in infants with very/extremely low birth weight].

Abstract

Objective: To compare the differences in breastfeeding rates and the incidence of clinical complications in very/extremely low birth weight infants with and without the use of donor milk banks.

Methods: Before and after the establishment of the donor milk bank, a total of 279 very/extremely low birth weight infants who were hospitalized in neonatal intensive care unit in a tertiary hospital in Beijing were selected. In the study, 136 infants who did not receive donated breast-feeding were included in control group and 143 infants who received donated breast-feeding were included in observation group. The clinical data of mothers and their infants were collected. The mother' s information included gestational age, maternal comorbidities, and mode of delivery. Infant information includes gender, weight, gestational age, duration of breastfeeding, total enteral feeding time, hospitalization time and incidence of complications (feeding intolerance, necrotizing enterocolitis, retinopathy of prematurity).

Results: The maternal ages were (33.5 ± 4.2) years in the observation group and (32.5 ± 3.9) years in the control group. Cesareans were performed in 95 cases (70.4%) and 81 cases (66.9%), respectively. The gestational ages of preterm infants were (29.2 ± 2.1) weeks and (29.1 ± 2.2) weeks, with birth weights of (1 140.5 ± 247.1) g and (1 169.4 ± 228.6) g, respectively. Newborn boys accounted for 72 cases (50.3%) in the observation group and 63 cases (46.3%) in the control group. No statistically significant differences were found in baseline characteristics between the two groups (all P > 0.05). After the use of donor milk banks, the rate of exclusive breastfeeding in very/low birth weight infants increased from 3.1% to 10.5% (χ²=5.778, P=0.016) during hospitalization, the time to full enteral feeding was shortened from 13 d to 10 d (Z=-4.567, P < 0.001), the first breastfeeding time was shortened from the third day of admission to the first day of admission (Z= -11.812, P < 0.001), the first breastfeeding of mother' s own milk was extended from the third day of admission to the fourth day of admission (Z=-4.652, P < 0.001), and the incidence of feeding intolerance during hospitalization was reduced from 34.0% to 10.0% (χ²=17.015, P < 0.001). There were no significant differences in the incidence of necrotizing enterocolitis, late-onset sepsis, retinopathy of prematurity and total length of hospital stay (P>0.05).

Conclusion: The use of donor milk bank can improve the breastfeeding rate, shorten the time to first breastfeeding, and reduce the incidence of feeding intolerance in very/extremely low birth weight infants, which provides a reference for the clinical treatment of very/extremely low birth weight infants.