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  • Letter to the Editor
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Reply to ‘Breast milk: the best lovebiotic’

Journal of Perinatology volume 35, page 666 (2015)Cite this article

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Dr Crealey and her associates are certainly to be commended for achieving a 100% breast milk exposure for extremely low birth weight (ELBW, <1000 g) infants and no cases of necrotizing enterocolitis in 2013.1, 2 I agree with the importance of increasing breast milk exposure, whether mother’s own or donor human milk, as breast milk has been shown to be one of the few factors known to decrease the rates of necrotizing enterocolitis.3, 4, 5 Our unit also enjoys a >99% breast milk exposure rate for all ELBW infants, and our necrotizing enterocolitis rate in very low birth weight infants (VLBW, <1500 g) runs in the 4 to 6.5% range over the past 3 years, with an admission rate of 220 to 250 VLBW infants per year.

I appreciate Dr Crealey’s comments1 about the limitations in abstracting the data from our study. Unfortunately, this study was only conceived after we noticed we were having complications with the new liquid human milk fortifier (HMF), and therefore could not be performed as a prospective randomized trial.6 Included in the limitations of a retrospective chart review, the only data that could be abstracted was that which had been obtained as clinically indicated at the time. This means that there were no guidelines in place for when to draw laboratory values or when to discontinue HMF. The laboratory values that were obtained are depicted below in Table 1. As already stated in the article,6 there was no feeding protocol in place at the time periods included in the study, and we acknowledge that differences in inter-physician care may certainly affect the results. As noted in the article, there were no major changes in feeding practices, medications or policies in our neonatal intensive-care unit (NICU) in the time span data were collected.

Table 1 Supplemental data of study participants
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References

  1. Crealey MR, Ludusan E, Philip RK . Breast milk: the best lovebiotic. J Perinatol 2015; 35 (8): 665.

    Article  CAS  Google Scholar 

  2. Philip R, Ismail A, Quinn C, Dunworth M, Hannigan A, O’Leary M . A ‘NEC free NICU’ through breastfeeding quality improvement project (QIP). Pediatrics 2015; 135 (Suppl 1): S13.

    Article  Google Scholar 

  3. Schanler RJ, Shulman RJ, Lau C . Feeding strategies for premature infants: beneficial outcomes of feeding fortified human milk versus preterm formula. Pediatrics 1999; 103 (6): 1150–1157.

    Article  CAS  Google Scholar 

  4. Narayanan I, Murthy NS, Prakash K, Gurjal VV . Randomised controlled trial of raw and Holder pasteurized human milk and of formula supplements on incidence of neonatal infection. Lancet 1984; 8412: 1111–1113.

    Article  Google Scholar 

  5. Sisk PM, Lovelady CA, Dillard RG, Gruber KJ, O’Shea TM . Early human milk feeding is associated with a lower risk of necrotizing enterocolitis in very low birth weight infants. J Perinatol 2007; 27: 428–433.

    Article  CAS  Google Scholar 

  6. Cibulskis CC, Armbrecht ES . Association of metabolic acidosis with bovine milk-based human milk fortifiers. J Perinatol 2015; 35: 115–119.

    Article  CAS  Google Scholar 

  7. Moya F, Sisk PM, Walsh KR, Berseth CL . A new liquid human milk fortifier and linear growth in preterm infants. Pediatrics 2012; 130 (4): e928–e935.

    Article  Google Scholar 

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  1. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Saint Louis University, St Louis, MO, USA

    C Cibulskis

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Cibulskis, C. Reply to ‘Breast milk: the best lovebiotic’. J Perinatol 35, 666 (2015). https://doi.org/10.1038/jp.2015.52

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