Oral Application of Mother’s Own Milk for Reducing Necrotizing Enterocolitis in Preterm Infants: An Updated Meta-Analysis of RCTs

Abstract

Background. Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are the major contributors to mortality and morbidity in preterm infants. This updated meta-analysis was aimed to assess the effects of mother’s milk on the incidence of NEC, LOS, and other clinical outcomes in preterm infants. Methods. PubMed, Embase, and the Cochrane library were searched for papers published up to October 2022. Results. A total of 13 RCTs with 1330 infants were included in the final analysis. Significant difference in NEC (stage 2 or 3) was found between the intervention group and the control group (RR = 0.508, 95% CI: 0.314–0.822, and $P=0.008$ ). The incidence of proven LOS (RR = 0.809, 95% CI: 0.610–1.071, and $P=0.139$ ) and death (RR = 0.800, 95% CI: 0.571–1.122, and $P=0.196$ ) was comparable between the two groups. Statistical differences in the incidence of proven or probable LOS (RR = 0.705, 95% CI: 0.577–0.862, and $P=0.001$ ) and length of hospitalization (WMD = −4.868, 95% CI: −6.608 to −3.128, and $P<0.001$ ) between the intervention group and the control group were observed. Conclusions. The results of this updated meta-analysis showed that compared to the placebo, mother’s milk provides better effects in reducing the incidences of NEC, proven or probable LOS, and the length of stay, whereas no significant benefit of mother’s milk was observed in reducing the incidence of proven LOS and death.