Showing papers in "Breastfeeding Medicine in 2015"

Racial and Ethnic Disparities in Breastfeeding

Abstract: This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted. Racial and ethnic minority women continue to have lower breastfeeding rates than white women and are not close to meeting the Healthy People 2020 goals. Minority women report many barriers to breastfeeding. Major efforts are still needed to improve breastfeeding initiation and duration rates among minority women in the United States. Obstetrician-gynecologists have a unique opportunity to promote and supp...

ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015

Abstract: A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

Breastfeeding outcome comparison by parity.

Abstract: Objective: Anecdotally, breastfeeding experiences differ between those who have previously nursed an infant and those who are primiparous. This analysis contrasted breastfeeding outcomes between primiparous women and those with previous experience spanning from maternity stay through 6 months postpartum. Study Design: A secondary analysis was conducted of data collected in a randomized, controlled trial with mothers and “well” newborns ≥34 weeks of gestation comparing two post–hospital discharge care models. Mothers completed an in-person interview during the postpartum stay and phone surveys at 2 weeks, 2 months, and 6 months where questionnaires related to breastfeeding were completed. All participants intended to breastfeed. Chi-squared and Wilcoxon rank sum tests were used to test for differences between parity groups. Breastfeeding duration by parity group was compared using a Kaplan–Meier plot and a logrank test. A Cox proportional hazards model was used to evaluate the relationship between...

Association of Timing of Initiation of Breastmilk Expression on Milk Volume and Timing of Lactogenesis Stage II Among Mothers of Very Low-Birth-Weight Infants

Abstract: Background: Feeding breastmilk to premature infants decreases morbidity but is often limited owing to an insufficient milk supply and delayed attainment of lactogenesis stage II. Early initiation of milk expression following delivery has been shown to increase milk production in mothers of very low-birth-weight (VLBW) infants. Although recommendations for milk expression in this population include initiation within 6 hours following delivery, little evidence exists to support these guidelines. This study compared milk volume and timing of lactogenesis stage II in mothers of VLBW infants who initiated milk expression within 6 hours following delivery versus those who initiated expression after 6 hours. Subjects and Methods: Forty mothers of VLBW infants were grouped according to when they initiated milk expression following delivery. Group I began milk expression within 6 hours, and Group II began expression after 6 hours. Milk volume was measured daily for the first 7 days and on Days 21 and 42. ...

Enhancing breastfeeding rates among African American women: a systematic review of current psychosocial interventions.

Abstract: The goals of this article are to provide a review of key interventions and strategies that impact initiation and duration of breastfeeding with particular focus on low-income African American mothers' maternal psychological vulnerabilities during the early postpartum period using a social ecological perspective as a guiding framework. Although modest gains have been achieved in breastfeeding initiation rates in the United States, a projected gap remains between infant feeding practices and national Healthy People breastfeeding goals set for 2020, particularly among African Americans. These disparities raise concerns that socially disadvantaged mothers and babies may be at increased risk for poor postnatal outcomes because of poorer mental health and increased vulnerability to chronic health conditions. Breastfeeding can be a protective factor, strengthening the relationship between mother and baby and increasing infant health and resilience. Evidence suggests that no single intervention can suffi...

Association between breastfeeding and breast cancer risk: evidence from a meta-analysis.

Abstract: Background: Quantification of the association between breastfeeding and breast cancer risk is still conflicting. Therefore, we conducted a meta-analysis to summarize the evidence from epidemiological studies of breastfeeding with the risk of breast cancer. Materials and Methods: Pertinent studies were identified by a search of PubMed between January 1, 2008 and July 31, 2014. The random-effect model was used. Sensitivity analysis, subgroups analysis, and publication bias were conducted. Results: Twenty-four articles with 27 studies involving 13,907 breast cancer cases were included in this meta-analysis. Pooled results suggested that breastfeeding was inversely associated with the risk of breast cancer. The summary relative risk (RR) of breast cancer for the ever compared with never categories of breastfeeding was 0.613 (95% confidence interval [CI], 0.442–0.850). An inverse association was also found for the longest compared with the shortest categories of breastfeeding with the risk of breast c...

The experience of breastfeeding the late preterm infant: a qualitative study.

Abstract: Background: Breastfeeding confers several health advantages to both infants and mothers. For reasons that are multifactorial, infants born even a few weeks prematurely are less likely to initiate breastfeeding, and those who breastfeed do so for a shorter duration than term infants. Materials and Methods: Qualitative analysis of structured telephone interviews was used to examine the breastfeeding experience of mothers of late preterm infants. Results: Our study found that, among mothers of late preterm infants, breastfeeding is both a positive bonding experience and a challenging experience, fraught with physical and medical struggles and feelings of guilt and failure. When looking back at the breastfeeding experience, many mothers recount negative experiences of milk supply concerns and breast pumping and report aspiring to be able to feed at breast more and pump less with their next child. Conclusions: Mothers of late preterm infants reported that breastfeeding was a bonding experience for the...

Goals for Human Milk Feeding in Mothers of Very Low Birth Weight Infants: How Do Goals Change and Are They Achieved During the NICU Hospitalization?

Abstract: Background: Little is known about human milk (HM) feeding goals for mothers of very low birth weight (VLBW) (<1,500 g birth weight) infants, especially for black mothers, for whom rates of VLBW birth are higher and lactation rates lower. This study examined the establishment, modification, and achievement of HM feeding goals during neonatal intensive care unit (NICU) hospitalization for mothers of VLBW infants and the influence of maternal race and income. Materials and Methods: A prospective cohort study measured maternal HM feeding goals (exclusive [EHM], partial, none) predelivery and during three time intervals: day of life (DOL) 1–14, 15–28, and 29–72. Goal achievement compared the goal for the time interval with the proportion of HM feedings received by the infant. Goal establishment, modification, and achievement were examined using chi-squared and contingency tables. Results: Three hundred fifty-two mother–infant dyads (53% black; 70% low-income; mean birth weight, 1,048 g) were studied. ...

Exclusive breastfeeding increased by an internet intervention.

Abstract: Background: Exclusive breastfeeding for 6 months is acknowledged universally as the optimal feeding method for infants in order to provide the greatest health and well-being gains for the infant and mother. Despite this, many women stop short of attaining this desired outcome for their infant. With the permeation of the Internet into most of society, the aim of this study was to evaluate the effect of a breastfeeding support Internet intervention on breastfeeding outcomes on women living in regional Western Australia. Materials and Methods: A nested intervention design within a longitudinal cohort titled the Regional Infant Feeding Study examined the effect of an Internet support Web site on the infant feeding practices of women living in regional Western Australia. Results: In total, 414 women participated in the Internet study and were randomly assigned to the control group (n=207) or the intervention group (n=207). Women enrolled in the intervention were significantly more likely to be exclusi...

Human Milk Macronutrients Content: Effect of Advanced Maternal Age

Abstract: Background: Little is known about the effect of advanced maternal age upon macronutrients of human milk. This study was designed to study contents of macronutrients (fat, lactose, and protein) in human milk collected in the first 2 weeks of life in older (≥35 years) compared with younger (<35 years) mothers. Subjects and Methods: Seventy-two lactating mothers (38 older, 34 younger) of newborns were recruited within the first 3 days of delivery. Macronutrient contents were measured at 72 hours, 7 days, and 14 days after delivery using infrared transmission spectroscopy. Results: The groups did not differ in terms of maternal prepregnancy weight, height, and diet or infant birth weight or gestational age. They differed significantly in terms of maternal age and maternal weight after pregnancy. Fat content in colostrum and carbohydrate content in mature milk were significantly higher in the older mothers group. Moreover, carbohydrates in mature milk correlated positively with maternal age. Fat conte...

Lactobacillus fermentum CECT 5716 Reduces Staphylococcus Load in the Breastmilk of Lactating Mothers Suffering Breast Pain: A Randomized Controlled Trial.

Abstract: Introduction: Recent results indicate that human mastitis and painful breastfeeding may be characterized by a mammary bacterial dysbiosis, a process in which the population of potential pathogens increases at the expense of the normal mammary microbiota. The objective of the present study is the evaluation of three different doses of Lactobacillus fermentum CECT5716 to reduce the load of Staphylococcus in the breastmilk of women suffering from painful breastfeeding. Materials and Methods: A randomized double-blinded controlled study with four study groups was performed. Three groups received the probiotic strain for 3 weeks at doses of 3×109 colony-forming units (CFU)/day, 6×109 CFU/day, or 9×109 CFU/day. The fourth group received a placebo of maltodextrin. The main outcome of the study was Staphylococcus counts in breastmilk. The secondary outcomes were Streptococcus, Lactobacillus, and total bacteria counts in breastmilk, immunoglobulin A and interleukin 8 concentrations in breastmilk, and brea...

ABM Clinical Protocol #18: Use of Antidepressants in Breastfeeding Mothers.

Abstract: A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

ABM Position on Breastfeeding-Revised 2015.

Abstract: The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection, and support of breastfeeding and human lactation. Our mission is to unite into one association members of the various medical specialties with this common purpose.

ABM Clinical Protocol #13: Contraception During Breastfeeding, Revised 2015

Abstract: A central goal of The Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

Breastfeeding and Maternal Hypertension and Diabetes: A Population-Based Cross-Sectional Study

Abstract: Objective: This study aimed to assess the association of breastfeeding and maternal hypertension and diabetes in Beijing, China. Subjects and Methods: A cross-sectional study was conducted in four urban communities of Beijing, China, with 9,128 parous women 40–81 years of age who had had only one lifetime birth. Each participant completed a detailed survey and accepted blood pressure measurement and blood glucose testing. Moreover, self-reported hypertension and diabetes were confirmed by review of medical records. Results: After the analysis was adjusted for the potential confounders, including age, body mass index (BMI), waist to hip ratio (WHR), working status, educational level, drinking, smoking, family history of hypertension, age of menarche, menopause, oral contraceptive use, age of child-bearing, and postpartum BMI, the odd ratio (OR) of hypertension was 1.18 (95% confidence interval [CI], 1.05–1.32) for women who did not breastfeed, compared with women who did. In addition, the ORs for ...

Infant Sleep and Night Feeding Patterns During Later Infancy: Association with Breastfeeding Frequency, Daytime Complementary Food Intake, and Infant Weight

Abstract: Infant sleep is a common concern for new parents. Although many expect a newborn infant to wake frequently, encouraging a baby to sleep through the night by a few months of age is seen as both a developmental aim and a parenting success. Many new mothers believe that their infants' diet is related to their sleep; formula milk or increased levels of solid food are often given in an attempt to promote sleep. However, the impact of these in later infancy is not understood. In the current study 715 mothers with an infant 6–12 months of age reported their infants' typical night wakings and night feeds alongside any breastfeeding and frequency of solid meals. Of infants in this age range, 78.6% still regularly woke at least once a night, with 61.4% receiving one or more milk feeds. Both night wakings and night feeds decreased with age. No difference in night wakings or night feeds was found between mothers who were currently breastfeeding or formula feeding. However, infants who received more milk or s...

Human milk and breastfeeding outcomes in infants with congenital heart disease.

Abstract: Background: Although human milk (HM) is the recommended form of infant nutrition, the provision of HM feeding among infants with congenital heart disease in the cardiac intensive care unit is unknown. Therefore the aim of the study was to understand the prevalence of pumping initiation, HM feeding, and breastfeeding patterns of mothers and their infants born with congenital heart disease. Subjects and Methods: This was a prospective cohort study conducted a large children's hospital with a cardiac referral program and unit. All women with infants with congenital heart disease were approached for enrollment in order to document HM prevalence. Results: The majority of women (89%) initiated lactation via pumping for their infants. On average, mothers pumped five to six times per day, and mothers were able to achieve a milk supply of over 500 mL/day. Once infants received enteral feeds, over 70% of the infant diet was HM. Very few (13%) infants fed via direct breastfeedings; rather, they received HM ...

Daily Breastmilk Volume in Mothers of Very Low Birth Weight Neonates: A Repeated-Measures Randomized Trial of Hand Expression Versus Electric Breast Pump Expression

Abstract: Background: There are no randomized trials comparing early exclusive hand expression (HE) with early exclusive electric pump expression (electric expression [EE]) for milk removal in mothers of very low birth weight (VLBW) infants. Subjects and Methods: Mothers of VLBW infants were randomized to exclusively HE or EE for the first 7 days postpartum. Daily volumes of milk were compared between groups for the first 28 days, adjusting for repeated measures. Results: The HE (n=12) and the EE (n=14) groups did not differ with respect to age, parity, single versus multiple gestation, or number of expression sessions per day. There were 728 values for daily milk volumes in the first 28 days, including 105 HE and 623 EE. Mothers using exclusive HE had significantly (p<0.05) less cumulative daily milk production throughout the first 7 days postpartum compared with exclusive EE. Mean cumulative milk production among mothers using HE in the first postpartum week remained approximately half that of those usin...

Milk Sharing in Practice: A Descriptive Analysis of Peer Breastmilk Sharing

Abstract: Peer breastmilk sharing has emerged in recent years as a subject of investigation and occasional controversy. Although researchers know that thousands of milk exchanges are facilitated through milk sharing Web sites every week, there is only limited research into milk sharing practices on the ground. This study examines these practices through a 102-item online survey that asked questions about milk sharing practices, perceptions of milk sharing, and demographic characteristics. Participants were recruited through social media sites specific to breastfeeding and parenting events in Central Florida. The sample consisted of 392 respondents. Data were analyzed using univariate analysis. We found that breastmilk sharing is a complex practice, showing high levels of overlap in which some donors are also recipients, and that cross-nursing sometimes occurs simultaneously with the exchange of expressed milk. Respondents often donated and received milk from people they knew; however, exchanging milk with strangers was also common. Many but not all used the Internet to facilitate milk exchange; participants used well-known milk sharing Web sites as well as their private virtual networks. The study found that most milk exchanges happen in-person as gifts and that selling and shipping breastmilk were rare. We suggest that further research is needed on breastmilk sharing practices to inform breastmilk safety research and policy recommendations.

Circadian Macronutrients Variations over the First 7 Weeks of Human Milk Feeding of Preterm Infants.

Abstract: Background: Little is known about circadian variations of macronutrients content of expressed preterm human milk (HM). This study evaluated diurnal variations of macronutrients and energy content of preterm HM over the first 7 weeks of lactation and tested the hypothesis that values obtained during a morning sample are predictive of those obtained from an evening sample. Materials and Methods: Expressed HM was obtained from 32 mothers of preterm infants (26–33 weeks in gestational age), who routinely expressed all their milk every 3 hours from the beginning of the second to the seventh week after delivery. One aliquot was obtained from the first morning expression and the second from the evening expression. Energy and macronutrients contents were measured using an HM analyzer. Results: Mean fat and energy contents of all samples obtained during the whole period were significantly higher in evening samples (p<0.0001). There were no significant differences between morning and evening carbohydrates ...

Relationship of maternal perceptions of workplace breastfeeding support and job satisfaction.

Abstract: Objectives: Decades of research supports the health benefits of breastfeeding. Prior research has shown that unsupportive work environments are frequently cited as reasons women abandon breastfeeding early. The objective of this study is to determine if mothers' perceptions of workplace lactation support are associated with job satisfaction. Materials and Methods: Female employees of Seattle Children's Hospital (SCH) and a large corporation were e-mailed a survey to measure perceptions of workplace lactation support. Women were eligible to participate if they had a child born within the last 5 years. Questions were asked about lactation support across five domains; organization, manager, coworker, time, and physical environment. The main outcome was job satisfaction. Linear regression models were run to evaluate the association between workplace support scores and the outcome of interest. Results: The survey was completed by 420 women at SCH and 131 women at the large corporation (response rate, ...

Prepregnancy obesity and breastfeeding noninitiation in the United States: an examination of racial and ethnic differences.

Abstract: Background: Prepregnancy overweight/obesity can adversely affect breastfeeding initiation, but studies examining this association among different racial/ethnic groups of U.S. women are limited. This study used a large, nationally representative sample to assess racial/ethnic differences in breastfeeding noninitiation among U.S. women of different body mass index (BMI) classifications. Materials and Methods: This study analyzed data from the Pregnancy Risk Assessment Monitoring System, including 95,141 women who delivered a live, singleton baby from 2009 to 2011 and provided BMI and breastfeeding information. Prepregnancy BMI was categorized as underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2), and obese (≥30.0 kg/m2). Breastfeeding initiation was reported as having ever breastfed after delivery (yes or no). Adjusted models, which included only potential confounders resulting in a 10% or greater change in estimate, generated adjusted odds ratios (AOR) and 95%...

Comparison of Breastmilk Odor and Vanilla Odor on Mitigating Premature Infants' Response to Pain During and After Venipuncture

Abstract: Objective: The main purpose of this study was to investigate the calming effects of breastmilk odor and vanilla odor on preterm infants during and after venipuncture. Subjects and Methods: One hundred thirty-five preterm infants were randomly selected and divided into three groups: control, vanilla odor, and breastmilk odor. Infants in the breastmilk group were exposed to breastmilk odor, and infants in the vanilla group were exposed to vanilla odor from 5 minutes before the start of sampling until 30 seconds after sampling. The Premature Infant Pain Profile was used for calculating quality of pain in infants during and after sampling. Results: Statistical analyses showed that both vanilla and breastmilk odors had calming effects on premature infants during sampling, but just breastmilk odor had calming effects on infants after the end of sampling. Compared with vanilla odor, breastmilk odor has more calming effects on premature infants. Conclusions: Breastmilk odor can be used for calming premat...

Maternal neuroendocrine serum levels in exclusively breastfeeding mothers.

Abstract: Background: Low milk supply is a common cause of early weaning, and supply issues are associated with dysregulation of thyroid function and prolactin. However, hormone levels compatible with successful breastfeeding are not well defined, limiting interpretation of clinical lab results. In this study we sought to quantify ranges for thyroid-stimulating hormone (TSH), free thyroxine (T4), total T4, and prolactin in a cohort of exclusively breastfeeding women. Materials and Methods: Women planning to breastfeed were recruited in the third trimester of pregnancy. Maternal endocrine function was assessed before and after a breastfeeding session at 2 and 8 weeks postpartum. We used paired t tests to determine whether values changed from the 2- to 8-week visit. Results: Of 52 study participants, 28 were exclusively breastfeeding, defined as only breastmilk feeds in the prior 7 days, at both the 2- and 8-week study visits. Endocrine function changed with time since delivery: the TSH level was higher, whe...

Barriers and Contributors to Breastfeeding in WIC Mothers: A Social Ecological Perspective.

Abstract: Background: In response to the Surgeon General's Call to Action to Support Breastfeeding, the goal of this research was to assess the barriers and positive contributors to breastfeeding initiation and duration in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants using the social ecological model (SEM). Materials and Methods: A cross-sectional design was used to survey WIC mothers (n = 283) in southern New Hampshire. Analysis of breastfeeding initiation and duration revealed statistically significant results primarily at the individual level of the SEM. Findings also showed influences at the interpersonal, community, and organizational levels. There were significant differences in beliefs toward breastfeeding between women who ever breastfed and women who never breastfed. Women who ever breastfed were more likely to agree that breastfeeding assists with losing baby weight (89% versus 77%; p = 0.03), babies fed breastmilk are less likely to get sick (86% ver...

Impact of Measuring Milk Production by Test Weighing on Breastfeeding Confidence in Mothers of Term Infants.

Abstract: Aim: The duration of exclusive breastfeeding is affected by maternal confidence and perception of milk supply, but objective measurement of milk supply is rarely used. Mothers of preterm infants have found measuring milk supply by in-home test weighing to be helpful to ascertain their infants' breastfeeding intake. This study aimed to determine if this technique affects breastfeeding confidence of mothers of term infants. Materials and Methods: Participants filled in a survey of their breastfeeding confidence and perceptions of breastfeeding behavior prior to and after a 24-hour period of recording the times of feeds, amounts of each breastfeed or bottle feed (expressed breastmilk or formula), and amounts of breastmilk expressed. Results: The breastfeeding confidence of at least 66% of mothers who were initially confident was maintained, and the breastfeeding confidence of at least 11% of mothers who were initially not confident was improved after objective measurement of milk supply and breastfe...

Higher Fat Content in Breastmilk Expressed Manually: A Randomized Trial

Abstract: Objective: This study aimed to evaluate the effect of milk expression method (manual expression versus electric pump) on the composition of breastmilk. Study Design: Data on 21 mothers of 21 newborns 48–72 hours postdelivery were collected and analyzed. The women were randomly assigned to express breastmilk manually followed by pump, or in reverse order. The fat, carbohydrate, and protein contents of the milk samples were analyzed using a human milk analyzer (Miris AB, Uppsala, Sweden). Results: The fat and energy contents of milk obtained through manual expression were higher than those obtained by pump (p=0.024 and p=0.04, respectively, by the Wilcoxon signed rank test). There were no significant differences in protein or carbohydrate content of milk obtained by either method of expression. The difference in fat content between milk obtained by the two methods was not correlated with mother's age, delivery method, gestational age at delivery, parity, or the interval between delivery and the tim...

Using the socio-ecological framework to determine breastfeeding obstacles in a low-income population in Tijuana, Mexico: healthcare services.

Abstract: Background: In Mexico, breastfeeding rates are one of the lowest of Latin America, with 14.4% of infants under 6 months being exclusively breastfed. Previous studies indicate that lack of support from healthcare services is a serious obstacle to breastfeeding mothers in Mexico. Our objective was to identify the main obstacles to breastfeeding presented by the healthcare services in a low-income population in Tijuana, Mexico. Materials and Methods: We used a socio-ecological framework to determine factors affecting breastfeeding practices. In four low-income communities in Tijuana we conducted focus groups and interviews with mothers, fathers, grandparents, and key informants. Interview notes and focus group transcripts were then studied in-depth independently by three researchers. The primary analytic technique was constant comparison. Results: One hundred twenty-nine subjects participated in this study: six focus groups (n=53) and 51 interviews among mothers, fathers, and grandparents, as well a...

Hospital outcomes of extremely low birth weight infants after introduction of donor milk to supplement mother's milk.

Abstract: Aim: This study evaluated the impact of an exclusive human milk diet to nourish extremely low birth weight infants in the neonatal intensive care unit. Materials and Methods: This multicenter pre–post retrospective study included all inborn infants <1,000 g admitted to four Level IV neonatal intensive care units either before or after implementing a donor human milk policy. The feeding protocol was unchanged in both periods. Collected data included maternal/infant demographics, infant clinical data, and enteral intake as mother's own milk, donor milk, and formula. Results: Two hundred one infants were enrolled. Infant growth and other clinical outcomes were similar in both groups. Exposure to mother's own milk at discharge was not different. Median time in oxygen and duration of mechanical ventilation were significantly higher among formula-fed infants (63 versus 192 hours [p=0.046] and 24 versus 60 hours [p=0.016], respectively). Conclusions: Our results add evidence supporting the safety of don...

Pasteurization of Breastmilk Decreases the Rate of Postnatally Acquired Cytomegalovirus Infections, But Shows a Nonsignificant Trend to an Increased Rate of Necrotizing Enterocolitis in Very Preterm Infants—A Preliminary Study

Abstract: Aim: This study assessed whether feeding preterm infants unpasteurized breastmilk (1) decreases the rate of late-onset sepsis and necrotizing enterocolitis and (2) increases the rate of postnatally acquired cytomegalovirus infections. Subjects and Methods: Between January 2008 and July 2013, preterm infants below 32 completed weeks of gestational age admitted to the neonatal intensive care unit of Innsbruck Medical University (Innsbruck, Austria) (n=344) were eligible for the study. Of those, 323 fed breastmilk were retrospectively enrolled in the study. Two groups were formed, with 164 infants being fed unpasteurized and 159 infants being fed pasteurized breastmilk. Results: There was no significant difference in the rate of late-onset sepsis or necrotizing enterocolitis between the unpasteurized and pasteurized breastmilk groups (late-onset sepsis, 15.9% versus 15.1% [p=0.486]; necrotizing enterocolitis, 2.4% versus 4.4% [p=0.254]). The number of infants diagnosed with postnatally acquired cyto...