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Perinatal with allergy, immunity, and infection

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G80 HUMAN MILK AND INFECTION IN PRETERM INFANTS: A SYSTEMATIC REVIEW

P. A. de Silva1, S. A. Spencer2, P. W. Jones3. 1Department of Physiology, Faculty of Medicine, Colombo, Sri Lanka; 2Neonatal Unit, Women and Children’s Division, University Hospital of North Staffordshire, Stoke-on-Trent; 3Department of Mathematics, Keele University, UK

Introduction: Among the many reasons used to advocate human milk feeding in preterm, low birthweight (LBW) infants is the surmise that human milk (HM) protects against infections. Clinical trials reporting an association between HM feeding and infection are few and the quality of existing research raises issues concerning interpretation of data from these trials.

Objective: To evaluate the available evidence on feeding HM v preterm formula on infection rates in preterm LBW infants.

Data Sources: Medline, Embase, Cinahl, Cochrane databases, previous reviews including cross references.

Selection Criteria: Any trials that investigated infection as an outcome of feeding HM v preterm formula in preterm infants <1500 g.

Results: Nine trials fulfilled the inclusion criteria. A total of 1136 infants (randomised controlled trials (RCT) n = 362, cohort studies n = 774) were studied. The number of exclusively HM fed infants were n = 113 (31.2 %) and n = 86 (11.1 %) in the RCTs and cohort studies, respectively. All nine trials reported significant reductions in infection rates in the HM groups compared with preterm formula. Methodological flaws relating to study design, sample size, varying definitions of HM feeding, and inadequate adjustment of covariates were present in all studies.

Conclusions: Despite the available data it is not possible to conclude that feeding HM protects preterm infants from infections. This review focuses on issues that affect the scientific validity and generalisability of the existing studies and the design of future studies that would circumvent the flaws found in current trials.

G81 PROPHYLACTIC INTRAVENOUS ANTIFUNGAL THERAPY FOR VLBW INFANTS: SYSTEMATIC REVIEW AND META-ANALYSIS

L. Clerihew1, N. Austin2, W. McGuire1. 1Tayside …

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