TOPLINE:

Infants born very preterm (< 32 weeks of gestational age) who were discharged from the hospital on any human milk feeding had significantly lower odds of respiratory hospital admissions during their first 18 months than those who were discharged from the hospital on exclusive formula feeding.

METHODOLOGY:

• Researchers conducted a prospective observational study to evaluate the association between human milk feeding and long-term respiratory morbidity during the first 18 months of life in infants born very preterm.
• They included 338 infants born very preterm (< 32 weeks of gestational age; median gestational age, 29.6 weeks; median birth weight, 1170 g) admitted to the neonatal unit at a tertiary referral hospital in Spain between 2020 and 2024.
• All infants received exclusively human milk during hospitalisation, which consisted of the mother's own milk and/or pasteurised donor human milk matched to recipients' gestational age and lactation stage; formula was introduced only shortly before discharge when needed.
• Infants were categorised on the basis of the type of feeding at discharge (exclusive or mixed human milk vs exclusive formula), the predominant type of human milk received during hospitalisation (> 50% donor human milk vs > 50% mother's own milk), and the severity of bronchopulmonary dysplasia (BPD; no BPD/grade 1 vs grade 2-3).
• All infants were followed up from birth until 18 months to assess long-term respiratory outcomes.

TAKEAWAY:

• Infants discharged on human milk feeding had fewer respiratory hospital admissions than those discharged on exclusive formula feeding (15% vs 25%), with 45% lower odds after adjusting for BPD (adjusted odds ratio, 0.55; P < .05 for both).
• Respiratory hospital admissions during the first 18 months of life, emergency department (ED) visits, or the incidence of BPD did not differ significantly between infants who received predominantly pasteurised donor human milk and those who received the mother's own milk during hospitalisation.
• Infants with grade 2-3 BPD experienced significantly higher respiratory hospital admissions (33% vs 15%) and had more frequent ED visits for bronchiolitis or bronchospasm (60% vs 36%) than those without BPD or with grade 1 BPD (P < .01 for both).
• The incidence of grade 2-3 BPD did not differ significantly according to the predominant type of human milk received during hospitalisation or the type of feeding at discharge.

IN PRACTICE:

"Our findings highlight the potential value of supporting human milk feeding at discharge in very preterm infants, both as a marker of intended post-discharge feeding practices and as a modifiable and feasible intervention to reduce respiratory morbidity," the authors wrote.

SOURCE:

This study was led by Amaia Merino‑Hernández, Hospital General Universitario Gregorio Marañón, Madrid, Spain. It was published online on March 06, 2026, in the European Journal of Pediatrics.

LIMITATIONS:

The study was conducted at a single centre, which may have limited the generalisability of the findings. Post-discharge breastfeeding duration was not systematically recorded. Respiratory morbidity was assessed using only hospital admissions and ED visits, which may have underestimated milder cases.

DISCLOSURES:

This study did not receive anyexternal funding. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.