Pediatric research · 2026
Impact of post-NICU human milk intake on respiratory outcomes in bronchopulmonary dysplasia.
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Cao Carol, Collaco Joseph M, Akangire Gangaram G, Anderson-Bell Dustin, Austin Eric D, Bhandari Anita, Fierro Julie L, Hayden Lystra P, Kelchtermans Jelte, Lai Khanh V, Manimtim Winston, Miller Audrey N, Moore Paul E, Nelin Leif D, Rice Jessica L, Sheils Catherine A, Siddaiah Roopa, Tracy Michael C, Abman Steven H, Baker Christopher D, Dress Carolyn, House Melissa A, Stephenson Nicole, Agarwal Amit, McGrath-Morrow Sharon A, Aoyama Brianna C
Аннотация
BACKGROUND: To assess whether human milk consumption after neonatal intensive care unit (NICU) discharge is associated with outpatient respiratory outcomes in infants and children with bronchopulmonary dysplasia (BPD).
METHODS: We conducted a retrospective longitudinal cohort study of children under 2 years followed in outpatient BPD clinics. Participants were categorized by post-NICU human milk exposure (any vs. none). Caregiver questionnaires assessed the presence and frequency of chronic respiratory symptoms and acute care usage. Baseline characteristics were compared descriptively, and logistic regression with clustering by subject evaluated associations between human milk intake and outcomes.
RESULTS: Among 1731 children, 445 (25.7%) received human milk after NICU discharge, and 1286 (74.3%) did not. After adjusting for potential confounders, human milk consumption was associated with lower odds of sick (OR: 0.65, p = 0.006) and emergency department visits (OR: 0.66, p = 0.015), antibiotic (OR: 0.58, p = 0.005) and steroid prescriptions (OR: 0.46, p < 0.001), and beta-agonist use in the prior 3 months (OR: 0.69, p = 0.008).
CONCLUSIONS: In our multicenter cohort of children with BPD, post-NICU human milk consumption was associated with decreased parent-reported acute healthcare utilization and chronic respiratory symptoms, supporting its role as a modifiable risk factor that may improve respiratory outcomes in children with BPD.
IMPACT: Human milk has been shown to decrease the incidence of bronchopulmonary dysplasia (BPD); however, limited data exist on the role of human milk intake after NICU discharge and its effect on long-term outpatient respiratory outcomes. Our findings demonstrate that post-NICU human milk intake is associated with decreased acute care usage and chronic respiratory symptoms in children with BPD, suggesting that human milk consumption is potentially a modifiable risk factor to improve outcomes. Further investigation using quantitative time-adjusted analyses, evaluating long-term respiratory consequences, and addressing barriers to use is needed to better define the role of human milk in this population.
METHODS: We conducted a retrospective longitudinal cohort study of children under 2 years followed in outpatient BPD clinics. Participants were categorized by post-NICU human milk exposure (any vs. none). Caregiver questionnaires assessed the presence and frequency of chronic respiratory symptoms and acute care usage. Baseline characteristics were compared descriptively, and logistic regression with clustering by subject evaluated associations between human milk intake and outcomes.
RESULTS: Among 1731 children, 445 (25.7%) received human milk after NICU discharge, and 1286 (74.3%) did not. After adjusting for potential confounders, human milk consumption was associated with lower odds of sick (OR: 0.65, p = 0.006) and emergency department visits (OR: 0.66, p = 0.015), antibiotic (OR: 0.58, p = 0.005) and steroid prescriptions (OR: 0.46, p < 0.001), and beta-agonist use in the prior 3 months (OR: 0.69, p = 0.008).
CONCLUSIONS: In our multicenter cohort of children with BPD, post-NICU human milk consumption was associated with decreased parent-reported acute healthcare utilization and chronic respiratory symptoms, supporting its role as a modifiable risk factor that may improve respiratory outcomes in children with BPD.
IMPACT: Human milk has been shown to decrease the incidence of bronchopulmonary dysplasia (BPD); however, limited data exist on the role of human milk intake after NICU discharge and its effect on long-term outpatient respiratory outcomes. Our findings demonstrate that post-NICU human milk intake is associated with decreased acute care usage and chronic respiratory symptoms in children with BPD, suggesting that human milk consumption is potentially a modifiable risk factor to improve outcomes. Further investigation using quantitative time-adjusted analyses, evaluating long-term respiratory consequences, and addressing barriers to use is needed to better define the role of human milk in this population.