Is Mother's Own Milk Lactoferrin Intake Associated with Reduced Neonatal Sepsis, Necrotizing Enterocolitis, and Death?
INTRODUCTION
Lactoferrin (LF) is a protective protein present in milk with anti-infective and immune-modulating properties.


OBJECTIVES
The aim of this study was to determine the association of maternal LF intake and mother's own milk intake in the first 10 days of life on the prevention of late-onset sepsis (LOS), necrotizing enterocolitis (NEC), or death in the first 8 weeks of life in newborns with a birth weight <2,000 g.


METHODS
A retrospective cohort study was conducted, with the exposure being the consumption of mother's own LF and mother's own milk in the first 10 days of life, and the outcome being LOS, NEC, or death during days 11 and 56 of life, analyzed by Cox regression.


RESULTS
Two hundred and ninety-nine infants were enrolled, including 240 with human LF intake information. The average daily human LF intake over days 4-10 of life was 283 mg/kg/day (IQR 114-606 mg/kg/day). The hazard ratio (HR) of mother's own milk LF intake ≥100 mg/kg/day in days 4-10 for LOS, NEC, or death was 0.297 (95% CI 0.156-0.568, p < 0.001); the adjusted HR was 0.752 (95% CI 0.301-1.877, p = 0.541). The adjusted HR of mother's own milk cumulative intake (days 4-10) of 54-344 mL/kg (25-75 quartiles) for LOS, NEC, or death was 0.414 (95% CI 0.196-0.873, p = 0.02). Infants who developed an event (LOS, NEC, or death) had significantly less median daily human LF intake than those that did not (89 vs. 334 mg/kg/day, respectively, p < 0.0001).


CONCLUSION
Consumption of higher amounts of mother's own milk in the first days of life is associated with less infection, NEC, and death. Early human milk intake should be strongly encouraged in all newborns.
['Ochoa|Theresa J|TJ|', 'Mendoza|Karina|K|', 'Carcamo|Cesar|C|', 'Zegarra|Jaime|J|', 'Bellomo|Sicilia|S|', 'Jacobs|Jan|J|', 'Cossey|Veerle|V|']
D020345:Enterocolitis, Necrotizing D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D007781:Lactoferrin D008895:Milk, Human D009035:Mothers D000071074:Neonatal Sepsis D012189:Retrospective Studies D018805:Sepsis
Lactoferrin Neonates Sepsis Infection Breast milk Preterm