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. 2025 Mar 29;12(4):431.
doi: 10.3390/children12040431.

Type and Volume of Milk Intake in Premature Infants <33 Weeks Gestational Age in the Neonatal Intensive Care Unit

Sudha Rani Narasimhan  1   2 , Maricela Vallejo  3 , Matthew Nudelman  1   4 , Priya Jegatheesan  1   2
Affiliations

Type and Volume of Milk Intake in Premature Infants <33 Weeks Gestational Age in the Neonatal Intensive Care Unit

Sudha Rani Narasimhan et al. Children (Basel). .

Abstract

Background: Understanding the patterns of milk intake in the neonatal intensive care unit (NICU) will allow opportunities to intervene to improve mother's milk supply.

Objective: To quantify the type and volume of milk intake in premature infants throughout the NICU stay.

Methods: This retrospective observational cohort study included infants born and admitted to the NICU at <33 weeks gestation from January 2014 to December 2017 who did not have contraindications for receiving mother's own milk (MOM). Daily volume of MOM, pasteurized donor milk (PDM), and formula throughout the NICU stay were collected. Infants were categorized as exclusive human milk diet (EHM) if they consumed MOM and PDM or mixed diet if they consumed formula and MOM and/or PDM. Demographics, feeding outcomes, growth outcomes, and neonatal morbidities were collected.

Results: Of 195 study infants, 133 (32%) received EHM. Cumulative volume and percent of MOM intake were greater in the EHM group compared to the mixed diet group. Age of first colostrum administration to infant was earlier in the EHM group than the mixed diet group (3.1 vs. 4.9, p = 0.013). By the second week of life, the EHM group received 100% of their feeds as MOM but the maximum MOM received in the mixed diet group was 63%. There was no difference in other feeding or neonatal outcomes between the groups.

Conclusion: The EHM group received colostrum earlier than those who received a mixed diet with formula and reached full MOM by the second week of life. This represents the opportunity to address challenges of milk supply of mothers with premature infants in the NICU in the first two weeks after birth.

Keywords: breast milk; breastfeeding; human milk; preterm feeding.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart for inclusion of participants. Total of 195 infants were eligible for the study.
Figure 2
Figure 2
Average percentage of feeding type. Average percent volume of milk type each day by PMA. Between 32 and 34 weeks PMA, there is a switch from PDM to formula in the mixed diet group.
Figure 3
Figure 3
Average percentage of feeding type in exclusive human milk (EHM) group and mixed diet group. Age at which 50% of the base milk was MOM in the EHM group was on day 4 and day 6 in the mixed diet group. The maximum percentage of MOM was 100% in the exclusive human milk group and 63% in the mixed diet group by 2 weeks of life.
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