Impact of post-NICU human milk intake on respiratory outcomes in bronchopulmonary dysplasia
In brief
Post-NICU human milk cuts emergency department visits by about one third in children with bronchopulmonary dysplasia
In a cohort of 1,731 BPD patients, the 445 who received any human milk after NICU discharge had roughly 35% lower odds of emergency visits, sick-day calls, and prescriptions for antibiotics, steroids, and bronchodilators compared with those who did not. The association persisted after adjusting for confounders, suggesting that continued human milk may be a modifiable factor to improve respiratory health, though prospective studies are needed to confirm causality.
- Journal
- Pediatric research (Q1)
- Published
- 2 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Carol Cao, Joseph M Collaco, Gangaram G Akangire, Dustin Anderson-Bell, Eric D Austin, Anita Bhandari, et al.
- PMID
- 42686837
- DOI
- 10.1038/s41390-026-05438-x
Why clinicians should know about it
- Picked for Neonatology (paper of the day, 7 September 2026): Human milk intake improves BPD respiratory outcomes
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.