Prevention of Cytomegalovirus Transmission via Breast Milk in Extremely Low Birth Weight Infants

  • H.S. Y
  • S.I. S
  • Y.J. J
 et al. 
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PURPOSE: Extremely low birth weight infants (ELBWIs) have a high risk of acquiring cytomegalovirus (CMV) infection via breast milk and consequently developing serious symptoms. We evaluated whether freeze-thawing or pasteurization could prevent postnatal CMV infection transmitted through breast milk in ELBWIs., MATERIALS AND METHODS: Medical records of 385 ELBWIs with whole milk feeding, and freeze-thawed or pasteurized breast milk feeding were reviewed retrospectively. Postnatally acquired CMV infection was defined as an initial negative and a subsequent positive on follow-up urine CMV DNA polymerase chain reaction screening tests. The incidence, clinical characteristics, symptoms, sequelae, and long-term outcome at corrected age [(CA): 2 years of CMV infection] were analyzed., RESULTS: While no infant developed CMV infection with whole milk (0/22) or pasteurized breast milk (0/62) feeding, postnatal CMV infection was diagnosed in 8% (27/301) of ELBWIs who were fed freeze-thawed breast milk. Gestational age in the CMV group was significantly lower than the control group. In 82% (22/27) of cases, CMV infection was symptomatic and was associated with increased ventilator days and >moderate bronchopulmonary dysplasia (BPD). Neurodevelopmental outcome and growth status at CA 2 years were not different between the study groups. Lower gestational age and freeze-thawed breast milk feeding >60% of total oral intake during the first 8 postnatal weeks were independent risk factors for acquiring postnatal CMV infection. BPD (>moderate) was the only significant adverse outcome associated with this CMV infection., CONCLUSION: Pasteurization but not freeze-thawing of breast milk eradicated the postnatal acquisition of CMV infection through breast milk.

Author-supplied keywords

  • *extremely low birth weight
  • *isolation and purification
  • *prevention and control
  • *transmission
  • *virology
  • Cytomegalovirus
  • Cytomegalovirus Infections/ep [Epidemiology]
  • Cytomegalovirus Infections/pc [Prevention]
  • Pregnancy Complications, Infectious/di [Diagnosis]
  • adult
  • breast feeding
  • breast milk
  • chemistry
  • evaluation study
  • female
  • gestational age
  • human
  • incidence
  • infant
  • lung dysplasia
  • male
  • newborn
  • polymerase chain reaction
  • pregnancy
  • retrospective study
  • risk factor
  • vertical transmission

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  • Yoo H.S.

  • Sung S.I.

  • Jung Y.J.

  • Lee M.S.

  • Han Y.M.

  • Ahn S.Y.

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