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Impact of early human milk on sepsis and health-care costs in very low birth weight infants

Journal of Perinatology volume 33, pages 514–519 (2013)Cite this article

Subjects

Abstract

Objective:

To study the incidence of sepsis and neonatal intensive care unit (NICU) costs as a function of the human milk (HM) dose received during the first 28 days post birth for very low birth weight (VLBW) infants.

Study design:

Prospective cohort study of 175 VLBW infants. The average daily dose of HM (ADDHM) was calculated from daily nutritional data for the first 28 days post birth (ADDHM-Days 1–28). Other covariates associated with sepsis were used to create a propensity score, combining multiple risk factors into a single metric.

Result:

The mean gestational age and birth weight were 28.1±2.4 weeks and 1087±252 g, respectively. The mean ADDHM-Days 1–28 was 54±39 ml kg−1 day−1 (range 0–135). Binary logistic regression analysis controlling for propensity score revealed that increasing ADDHM-Days 1–28 was associated with lower odds of sepsis (odds ratio 0.981, 95% confidence interval 0.967–0.995, P=0.008). Increasing ADDHM-Days 1–28 was associated with significantly lower NICU costs.

Conclusion:

A dose–response relationship was demonstrated between ADDHM-Days 1–28 and a reduction in the odds of sepsis and associated NICU costs after controlling for propensity score. For every HM dose increase of 10 ml kg−1 day−1, the odds of sepsis decreased by 19%. NICU costs were lowest in the VLBW infants who received the highest ADDHM-Days 1–28.

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Acknowledgements

We acknowledge statistical assistance from Michael E Schoeny, PhD and David B Henry, PhD. This study was funded by NIH Grant NR010009.

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Authors and Affiliations

  1. Department of Pediatrics, Rush University Medical Center, Chicago, IL, USA

    A L Patel, H R Bigger & P P Meier

  2. College of Nursing, Rush University Medical Center, Chicago, IL, USA

    A L Patel, T J Johnson, J L Engstrom, L F Fogg, B J Jegier & P P Meier

  3. Department of Health Systems Management, Rush University Medical Center, Chicago, IL, USA

    T J Johnson

  4. Frontier Nursing University, Hyden, KY, USA

    J L Engstrom

Authors
  1. A L Patel
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  2. T J Johnson
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  4. L F Fogg
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  6. H R Bigger
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Correspondence to A L Patel.

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Patel, A., Johnson, T., Engstrom, J. et al. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol 33, 514–519 (2013). https://doi.org/10.1038/jp.2013.2

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Keywords

  • premature infant
  • breast milk
  • infection
  • economics
  • health-care costs

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