Breastfeeding May Protect Infants from Hospital-acquired Infections

The first days of life are crucial for any newborn, and a new study has found that a protein in breast milk plays an important role in protecting infants from catching hospital-acquired infections.

The World Health Organization (WHO) recommends that infants exclusively receive breast milk for the first six months of their lives, and studies show that breastfeeding is important to the health of both mother and child. WHO health officials tout the protective benefits of breast milk for babies, to help prevent respiratory infections such as pneumonia, infections causing diarrhea, and other diseases that can cause infant mortality. A Centers for Disease Control report notes that while the rate of breastfeeding has continued to rise in the United States, it is still below target rates set by the American Academy of Pediatrics for exclusive breastfeeding until six months. Although more than 80% of infants start out being breastfed, just 51.8% are still receiving breast milk at six months, and only 22.3% exclusively so.

A new study from researchers at the University of Missouri and the University of Southern California further investigates the role of breast milk in infant health. The paper’s authors cite past research showing that during vaginal delivery, babies receive important intestinal and skin microbiota from their mothers to aid in their immune system development. Previous studies have investigated how babies born by cesarean delivery may miss out on an important source of beneficial intestinal flora, affecting the early development of the immune system. Breast milk contains micronutrients and compounds that help build up infant immunity and protect against infections, and the milk a mother produces in the first days after delivery, called colostrum, contains important immunologic compounds.

In the new study, published in the Journal of Pediatrics, researchers investigated the effects of lactoferrin, a protein component of breast milk highly concentrated in colostrum and that research shows contains antimicrobial and immune-building effects. They enrolled 120 premature infants born at very low birth weight and admitted to two neonatal intensive care units (NICU), more than 70% of whom had been delivered via cesarean section. Pre-term babies admitted to NICUs are typically fed intravenously, and can miss out on the benefits of their mothers’ colostrum. Likewise, these babies are at higher risk of getting hospital-acquired infections such as ventilator-associated pneumonia and central line-associated bloodstream infections.

The study ran from July 2009 to January 2012, with infants in the study ranging in birth weight from 1 pound, 10 ounces to 3 pounds, 4 ounces. The infants were split into two even groups of 60 each, with one half receiving lactoferrin supplementation in their feeding tubes and the other half receiving a placebo. Each infant was enrolled in the study for 28 days.

The researchers studied the fecal samples of infants in the study, and noted that very low birth weight babies given lactoferrin had lower intestinal levels of pathogenic staphylococci, resulting in bloodstream and central-line infections without any adverse effects. Lactoferrin can also balance out the fecal microbiome levels of Enterobacteriaceae. Giving lactoferrin to NICU infants may also reduce bacterial colonization in catheters, feeding tubes, and ventilators, say the authors, warranting more investigation.

"The majority of diseases affecting newborn preemies are hospital-acquired infections such as meningitis, pneumonia, and urinary tract infections," said Michael Sherman, MD, professor emeritus in the Department of Child Health at the MU School of Medicine and lead author of the study, in a press release. "Not only did we find that lactoferrin, a protein found in breast milk, could reduce hospital infections among preemies, but we also measured the safety of feeding the protein to newborns."

The cost for a dose of lactoferrin is $25 to $500 each, and while that may seem high, the authors note a Journal of the American Medical Association study showing $9.8 billion in annual costs due to hospital-acquired infections. "While a large-scale clinical trial is needed before lactoferrin becomes a standard treatment protocol in NICUs, our results show the safety of lactoferrin and provide an initial report of efficiency related to reducing hospital-acquired infections," Sherman said.

As breastfeeding rates continue to rise, studies such as this emphasize the health benefits of breast milk for infants. According to the CDC, breastfeeding is one of the best ways to protect the health of a baby, and women have a high success and adherence rate with support from family, community members, doctors, employers, and policymakers.