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Exclusive human milk diet reduces incidence of severe intraventricular hemorrhage in extremely low birth weight infants



Compare the incidence of severe (grade III/IV) intraventricular hemorrhage (IVH) and/or periventricular leukomalacia (PVL) between two groups of ELBW infants based on diet until 34 weeks corrected gestational age (CGA): (1) Exclusive human milk (EHM)—mother’s own and/or pasteurized donor human milk, human milk-derived fortifier, and oral care with colostrum/human milk vs. (2) non-EHM—bovine formula or mother’s own milk with bovine-derived fortifier.

Study design

Retrospective observational study of two groups of ELBW infants based on diet until 34 weeks CGA.


There were n = 306 infants, 127 EHM and 179 non-EHM. Demographics and morbidities were similar except higher antenatal steroids and NEC in EHM group. The rate of severe IVH/PVL was lower in EHM compared to non-EHM group (7 vs. 18%, p < 0.006).


EHM diet had an independent neuroprotective effect and was associated with decreased incidence of severe IVH/PVL, supporting the need of EHM in ELBW infants.

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Fig. 1: Incidence of IVH/PVL by type of EHM.


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Author information




KC, AR, and BP contributed to the design of the experiment. KC and AR played a role in the acquisition of the data and KC, AR, and BP participated in the data analysis and interpretation. All coauthors played an active role in both the preparation and editing of this manuscript. All authors have read and agreed to the content of the manuscript.

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Correspondence to Amanda Rahman.

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Carome, K., Rahman, A. & Parvez, B. Exclusive human milk diet reduces incidence of severe intraventricular hemorrhage in extremely low birth weight infants. J Perinatol 41, 535–543 (2021).

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