human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Preterm infants are immunologically immature at birth . Previous studies have demonstrated that human milk protects against infection in full-term infants , but there are few studies of its effect for preterm infants . OBJECTIVE To examine the effect of human milk feedings on infection incidence among very low birth weight ( VLBW ) infants during their initial hospitalization . STUDY DESIGN The sample consisted of 212 consecutive VLBW infants admitted to the Georgetown University Medical Center neonatal intensive care unit ( NICU ) during 1992 - 1993 and surviving to receive enteral feeding .  Type of feeding ( human milk vs formula ) , presence of infection and sepsis/meningitis ( clinical signs and positive cultures for pathogenic organisms ) , and potential confounding variables were abstract ed from medical records . Multiple logistic regression was used to control for confounders . RESULTS The incidence of infection ( human milk [ 29.3 % ] vs formula [ 47.2 % ] ) and sepsis/meningitis ( human milk [ 19.5 % ] vs formula [ 32.6 % ] ) differed significantly by type of feeding . Major risk factors for infection were similar in both groups . Human milk feeding was independently correlated with a reduced odds of infection ( odds ratio [ OR ] = 0.43 ; 95 % confidence interval [ CI ] : 0.23 - 0.81 ) , controlling for gestational age , 5-minute Apgar score , mechanical ventilation days , and days without enteral feedings ; and was independently correlated with a reduced odds of sepsis/meningitis ( OR = 0.47 , 95 % CI:0.23 - 0 . 95 ) , controlling for gestational age , mechanical ventilation days , and days without enteral feedings . CONCLUSIONS The incidence of any infection and sepsis/meningitis are significantly reduced in  human milk-fed VLBW infants compared with exclusively formula-fed VLBW infants BACKGROUND . We previously reported beneficial effects of breast milk ingestion by infants with extremely low birth weight in the NICU on developmental outcomes at 18 months ’ corrected age . The objective of this study was to determine whether these effects of breast milk in infants with extremely low birth weight persisted at 30 months ’ corrected age . METHODS . Nutrition data , including enteral and parenteral feeds , were prospect ively collected , and 30 months ’ corrected age follow-up assessment s were completed on 773 infants with extremely low birth weight who participated in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial . A total of 593 ingested some breast milk during the neonatal hospitalization , and 180 ingested none . Neonatal feeding characteristics and morbidities and 30-month interim history , neurodevelopmental outcomes , and growth parameters were analyzed . Children were divided into quintiles of breast milk volume to evaluate the effects of volume of human milk ingested during the NICU hospitalization . RESULTS . At 30 months , increased ingestion of breast milk was associated with higher Bayley Mental Developmental Index scores , higher Bayley behavior score percentiles for emotional regulation , and fewer rehospitalizations between discharge and 30 months . There were no differences in growth parameters or cerebral palsy . For every 10 mL/kg per day increase in breast milk , the Mental Developmental Index increased by 0.59 points , the Psychomotor Developmental Index by 0.56 points , and the total behavior percentile score by 0.99 points , and the risk of rehospitalization between discharge and 30 months decreased by 5 % . CONCLUSIONS . Beneficial effects of ingestion of breast milk in the NICU persist at 30 months ’ corrected age in this vulnerable extremely low birth weight population . Continued efforts must be made to offer breast milk to all extremely low birth weight infants both in the NICU and after discharge OBJECTIVE To compare the duration of parenteral nutrition , growth , and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula ( BOV ) or donor human milk and human milk-based human milk fortifier ( HUM )  , in a r and omized trial of formula vs human milk . STUDY DESIGN Multicenter r and omized controlled trial . The authors studied extremely preterm infants whose mothers did not provide their milk . Infants were fed either BOV or an exclusive human milk diet of pasteurized donor human milk and HUM . The major outcome was duration of parenteral nutrition . Secondary outcomes were growth , respiratory support , and necrotizing enterocolitis ( NEC ) . RESULTS Birth weight ( 983 vs 996 g ) and  gestational age ( 27.5 vs 27.7 wk ) , in BOV and HUM , respectively , were similar . There was a significant difference in median parenteral nutrition days : 36 vs 27 , in BOV vs HUM , respectively ( P = .04 ) . The incidence of NEC in BOV was 21 % ( 5 cases ) vs 3 % in HUM ( 1 case ) , P = .08 ; surgical NEC was significantly higher in BOV ( 4 cases ) than HUM ( 0 cases ) , P = .04 . CONCLUSIONS In extremely preterm infants given exclusive diets of preterm formula vs human milk , there was a significantly greater duration of parenteral nutrition and higher rate of surgical NEC in infants receiving preterm formula . This trial supports the use of an exclusive human milk diet to nourish extremely preterm infants in the neonatal intensive care unit Despite potential benefits , human milk may fail to meet preterm infants ' nutrient requirements . We tested the hypothesis that fortified breast milk , fed alone or with preterm formula , would improve neurodevelopment and growth at 18-mo follow-up without adverse short-term clinical or biochemical consequences . Two hundred seventy-five preterm infants from two medical centers ( birth weight < 1850 g ; mean gestation 29.8 + /- 2.7 wk ) whose mothers chose to provide breast milk were r and omly assigned to receive for a mean of 39 d a multinutrient fortifier or control supplement containing phosphate and vitamins . Breast milk comprised 47.6 % and 46.4 % of enteral intake in fortified and control groups , respectively ; preterm formula supplements were used when insufficient breast milk was available . Overall , there were no significant growth advantages with fortification ; although , when breast milk exceeded 50 % of intake , fortification promoted faster weight gain ( an advantage of 1.6 g.kg-1.d-1 ; 95 % CI : 0.1 , 3.1 ; P < 0.05 ) . Compared with control infants , the fortified group showed 1 ) higher plasma urea from week 2 ( P = 0.04 ) , 2 ) higher plasma calcium ( mean 2.34 + /- 0.01 compared with 2.27 + /- 0.02 mmol/L ; P = 0.003 ) , 3 ) a greater rise in alkaline phosphatase by week 6 ( P = 0.04 ) , 4 ) more clinical infections ( suspected plus proven ; 43 % compared with 31 % , P = 0.04 ) , 5 ) a nonsignificantly increased incidence of necrotizing enterocolitis ( 5.8 % compared with 2.2 % , P = 0.12 ) , and 6 ) higher white cell and platelet counts . Developmental scores at 18 mo were slightly but not significantly higher in the fortified group . This study confirmed that breast milk fortifiers can improve short-term growth ( when breast milk intakes are high ) ; but beneficial effects on long-term development remained unproven . Future research is required to evaluate potential adverse consequences and explore more optimal fortification strategies Poor weight gain observed in preterm infants who were fed expressed breast milk compared with those fed a cows ' milk formular  prompted a detailed study of early postnatal growth in preterm infants fed these two milks . 68 infants were divided into two categories by gestational age at birth ( i ) 28 - 32 weeks ( n=28 ) , ( ii ) 33 - 36 weeks ( n=40 ) . They were r and omly allocated to a feed of expressed breast milk or a milk formula ( Ostermilk 1 ) . Rates of weight gain , linear growth , and head circumference growth were evaluated over two periods : birth-1 month , 1 - 2 months . The younger group who were fed breast milk showed slower overall growth rates over the first month than those fed formula . In the second month , and for the older infants over both of the 2-monthly periods , growth rates were similar in the two feeding regimens . It is concluded that expressed breast milk is inadequate for the growth of very immature preterm infants during early postnatal life Background : Feeding preterm infants human  milk has a beneficial effect on the risk of late-onset sepsis ( LOS ) . Due to lack of microbiological st and ards , practice s such as pasteurization of mother ’s own milk differ widely among neonatal intensive care units worldwide . Objectives : To investigate whether pasteurization of mother ’s own milk for very-low-birth-weight ( VLBW ) infants influences the incidence and severity of infection-related outcomes . Methods : In this r and omized controlled trial , preterm infants ( gestational age < 32 weeks and /or birth weight < 1,500 g ) received either raw or pasteurized mother ’s own milk during the first 8 weeks of life . The primary outcome was the incidence of proven LOS . A dose-response relation was verified , i.e. the dependence of the risk of sepsis on the actual and cumulative quantities of mother ’s own milk . Results : This study included 303 VLBW infants ( mean birth weight : 1,276 g ; mean gestational age : 29 weeks ) whose baseline and nutritional characteristics were similar . The incidence of laboratory-confirmed sepsis was not statistically different in infants fed raw milk compared to infants who received pasteurized milk : 22/151 ( 0.15 , CI : 0.08–0.20 ) and 31/152 ( 0.20 , CI : 0.14–0.27 ) , respectively ( RR : 0.71 ; 95 % CI : 0.43–1.17 ) . A significant dose-response relation was observed between the adjusted quantity of enteral feeding and the risk of LOS , regardless of the type of feeding . Conclusion : For preterm infants , pasteurization of mother ’s own milk shows a trend towards an increase in infectious morbidity , although no statistical significance was reached . Practice s should focus on collection , storage and labeling procedures to ensure the safety and quality of expressed milk OBJECTIVE This study tested the hypothesis that feeding an exclusively human milk ( EHM ) diet  to premature infants reduces the incidence of necrotizing enterocolitis ( NEC ) associated with enteral feeding . STUDY DESIGN An observational study for infants born at less than 33 weeks of gestational age was performed in a single neonatal intensive care unit . An EHM diet prospect ively eliminated bovine-based artificial milk , including bovine-based fortifier , through 33 weeks postmenstrual age ( PMA ) . The clinical data from a 2.5-year interval of the EHM diet were compared with data from the previous 6.5 years for similar infants who received bovine-based milk products  before 33 weeks PMA . RESULTS In the EHM diet cohort , 148 of 162 infants ( 91 % ) received EHM through 33 weeks PMA . In order to achieve an EHM diet , 140 of 162 infants ( 86 % ) received their own mother 's milk , and 98 of 162 infants ( 60 % ) received donor human milk . The EHM cohort was also fed a human milk-based fortifier to truly eliminate bovine products . The distribution of NEC onset in the EHM cohort was significantly different from that in the control cohort for the day of onset ( p=0.042 ) and the PMA at onset ( p=0.011 ) . In the control cohort , NEC onset after Day 7 of life occurred in 15 of 443 infants ( 3.4 % ) , significantly more than in the EHM cohort where NEC occurred in two of 199 infants ( 1 % ) ( p=0.009 ) . CONCLUSIONS Changing to an EHM milk diet through 33 weeks PMA reduced the incidence of NEC associated with enteral feeding BACKGROUND Retinopathy of prematurity(ROP ) is the most common serious ophthalmic disease in preterm infants .  Human milk may provide a protective effect for ROP ; however , beneficial effects of human milk preclude r and omized trials . Therefore , we conducted a retrospective analysis comparing early postnatal nutrition with ROP development . OBJECTIVE Evaluate relationship between early postnatal nutriture and ROP surgery . DESIGN / METHODS Nutrition data was collected for inborn AGA infants , BW 700 - 1000 g.  ROP surgery was the primary outcome variable . A single pediatric ophthalmologist supervised examinations . All infants received triweekly IM vitamin A as chronic lung disease prophylaxis ( Tyson : NEJM , 1999 ) . RESULTS  BW and gestational age were 867+/-85 g and 26.3+/-1.2 weeks ( n=77 , mean+/-1SD ) . ROP surgery infants(n=11 ) received more parenteral nutrition , 1648 mL , and less human milk , 13.8 mL/kg-day , and vitamin E , 1.4 mg/kg-day , during the second postnatal week . Human milk was a negative predictor for 
    Output:
    
agent
HM provided a clear protective effect against NEC , with an approximate 4 % reduction in incidence .
HM also provided a possible reduction in LOS , severe ROP and severe NEC .
Particularly for NEC , any volume of HM is better than EPTF , and the higher the dose the greater the protection .
Evidence regarding pasteurisation is inconclusive , but it appears to have no effect on some outcomes .
Improving the intake of mother ’s own milk ( MOM ) and /or donor HM results in small improvements in morbidity in this population
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Preterm infants are immunologically immature at birth . Previous studies have demonstrated that human milk protects against infection in full-term infants , but there are few studies of its effect for preterm infants . OBJECTIVE To examine the effect of human milk feedings on infection incidence among very low birth weight ( VLBW ) infants during their initial hospitalization . STUDY DESIGN The sample consisted of 212 consecutive VLBW infants admitted to the Georgetown University Medical Center neonatal intensive care unit ( NICU ) during 1992 - 1993 and surviving to receive enteral feeding .  Type of feeding ( human milk vs formula ) , presence of infection and sepsis/meningitis ( clinical signs and positive cultures for pathogenic organisms ) , and potential confounding variables were abstract ed from medical records . Multiple logistic regression was used to control for confounders . RESULTS The incidence of infection ( human milk [ 29.3 % ] vs formula [ 47.2 % ] ) and sepsis/meningitis ( human milk [ 19.5 % ] vs formula [ 32.6 % ] ) differed significantly by type of feeding . Major risk factors for infection were similar in both groups . Human milk feeding was independently correlated with a reduced odds of infection ( odds ratio [ OR ] = 0.43 ; 95 % confidence interval [ CI ] : 0.23 - 0.81 ) , controlling for gestational age , 5-minute Apgar score , mechanical ventilation days , and days without enteral feedings ; and was independently correlated with a reduced odds of sepsis/meningitis ( OR = 0.47 , 95 % CI:0.23 - 0 . 95 ) , controlling for gestational age , mechanical ventilation days , and days without enteral feedings . CONCLUSIONS The incidence of any infection and sepsis/meningitis are significantly reduced in  human milk-fed VLBW infants compared with exclusively formula-fed VLBW infants BACKGROUND . We previously reported beneficial effects of breast milk ingestion by infants with extremely low birth weight in the NICU on developmental outcomes at 18 months ’ corrected age . The objective of this study was to determine whether these effects of breast milk in infants with extremely low birth weight persisted at 30 months ’ corrected age . METHODS . Nutrition data , including enteral and parenteral feeds , were prospect ively collected , and 30 months ’ corrected age follow-up assessment s were completed on 773 infants with extremely low birth weight who participated in the National Institute of Child Health and Human Development Neonatal Research Network Glutamine Trial . A total of 593 ingested some breast milk during the neonatal hospitalization , and 180 ingested none . Neonatal feeding characteristics and morbidities and 30-month interim history , neurodevelopmental outcomes , and growth parameters were analyzed . Children were divided into quintiles of breast milk volume to evaluate the effects of volume of human milk ingested during the NICU hospitalization . RESULTS . At 30 months , increased ingestion of breast milk was associated with higher Bayley Mental Developmental Index scores , higher Bayley behavior score percentiles for emotional regulation , and fewer rehospitalizations between discharge and 30 months . There were no differences in growth parameters or cerebral palsy . For every 10 mL/kg per day increase in breast milk , the Mental Developmental Index increased by 0.59 points , the Psychomotor Developmental Index by 0.56 points , and the total behavior percentile score by 0.99 points , and the risk of rehospitalization between discharge and 30 months decreased by 5 % . CONCLUSIONS . Beneficial effects of ingestion of breast milk in the NICU persist at 30 months ’ corrected age in this vulnerable extremely low birth weight population . Continued efforts must be made to offer breast milk to all extremely low birth weight infants both in the NICU and after discharge OBJECTIVE To compare the duration of parenteral nutrition , growth , and morbidity in extremely premature infants fed exclusive diets of either bovine milk-based preterm formula ( BOV ) or donor human milk and human milk-based human milk fortifier ( HUM )  , in a r and omized trial of formula vs human milk . STUDY DESIGN Multicenter r and omized controlled trial . The authors studied extremely preterm infants whose mothers did not provide their milk . Infants were fed either BOV or an exclusive human milk diet of pasteurized donor human milk and HUM . The major outcome was duration of parenteral nutrition . Secondary outcomes were growth , respiratory support , and necrotizing enterocolitis ( NEC ) . RESULTS Birth weight ( 983 vs 996 g ) and  gestational age ( 27.5 vs 27.7 wk ) , in BOV and HUM , respectively , were similar . There was a significant difference in median parenteral nutrition days : 36 vs 27 , in BOV vs HUM , respectively ( P = .04 ) . The incidence of NEC in BOV was 21 % ( 5 cases ) vs 3 % in HUM ( 1 case ) , P = .08 ; surgical NEC was significantly higher in BOV ( 4 cases ) than HUM ( 0 cases ) , P = .04 . CONCLUSIONS In extremely preterm infants given exclusive diets of preterm formula vs human milk , there was a significantly greater duration of parenteral nutrition and higher rate of surgical NEC in infants receiving preterm formula . This trial supports the use of an exclusive human milk diet to nourish extremely preterm infants in the neonatal intensive care unit Despite potential benefits , human milk may fail to meet preterm infants ' nutrient requirements . We tested the hypothesis that fortified breast milk , fed alone or with preterm formula , would improve neurodevelopment and growth at 18-mo follow-up without adverse short-term clinical or biochemical consequences . Two hundred seventy-five preterm infants from two medical centers ( birth weight < 1850 g ; mean gestation 29.8 + /- 2.7 wk ) whose mothers chose to provide breast milk were r and omly assigned to receive for a mean of 39 d a multinutrient fortifier or control supplement containing phosphate and vitamins . Breast milk comprised 47.6 % and 46.4 % of enteral intake in fortified and control groups , respectively ; preterm formula supplements were used when insufficient breast milk was available . Overall , there were no significant growth advantages with fortification ; although , when breast milk exceeded 50 % of intake , fortification promoted faster weight gain ( an advantage of 1.6 g.kg-1.d-1 ; 95 % CI : 0.1 , 3.1 ; P < 0.05 ) . Compared with control infants , the fortified group showed 1 ) higher plasma urea from week 2 ( P = 0.04 ) , 2 ) higher plasma calcium ( mean 2.34 + /- 0.01 compared with 2.27 + /- 0.02 mmol/L ; P = 0.003 ) , 3 ) a greater rise in alkaline phosphatase by week 6 ( P = 0.04 ) , 4 ) more clinical infections ( suspected plus proven ; 43 % compared with 31 % , P = 0.04 ) , 5 ) a nonsignificantly increased incidence of necrotizing enterocolitis ( 5.8 % compared with 2.2 % , P = 0.12 ) , and 6 ) higher white cell and platelet counts . Developmental scores at 18 mo were slightly but not significantly higher in the fortified group . This study confirmed that breast milk fortifiers can improve short-term growth ( when breast milk intakes are high ) ; but beneficial effects on long-term development remained unproven . Future research is required to evaluate potential adverse consequences and explore more optimal fortification strategies Poor weight gain observed in preterm infants who were fed expressed breast milk compared with those fed a cows ' milk formular  prompted a detailed study of early postnatal growth in preterm infants fed these two milks . 68 infants were divided into two categories by gestational age at birth ( i ) 28 - 32 weeks ( n=28 ) , ( ii ) 33 - 36 weeks ( n=40 ) . They were r and omly allocated to a feed of expressed breast milk or a milk formula ( Ostermilk 1 ) . Rates of weight gain , linear growth , and head circumference growth were evaluated over two periods : birth-1 month , 1 - 2 months . The younger group who were fed breast milk showed slower overall growth rates over the first month than those fed formula . In the second month , and for the older infants over both of the 2-monthly periods , growth rates were similar in the two feeding regimens . It is concluded that expressed breast milk is inadequate for the growth of very immature preterm infants during early postnatal life Background : Feeding preterm infants human  milk has a beneficial effect on the risk of late-onset sepsis ( LOS ) . Due to lack of microbiological st and ards , practice s such as pasteurization of mother ’s own milk differ widely among neonatal intensive care units worldwide . Objectives : To investigate whether pasteurization of mother ’s own milk for very-low-birth-weight ( VLBW ) infants influences the incidence and severity of infection-related outcomes . Methods : In this r and omized controlled trial , preterm infants ( gestational age < 32 weeks and /or birth weight < 1,500 g ) received either raw or pasteurized mother ’s own milk during the first 8 weeks of life . The primary outcome was the incidence of proven LOS . A dose-response relation was verified , i.e. the dependence of the risk of sepsis on the actual and cumulative quantities of mother ’s own milk . Results : This study included 303 VLBW infants ( mean birth weight : 1,276 g ; mean gestational age : 29 weeks ) whose baseline and nutritional characteristics were similar . The incidence of laboratory-confirmed sepsis was not statistically different in infants fed raw milk compared to infants who received pasteurized milk : 22/151 ( 0.15 , CI : 0.08–0.20 ) and 31/152 ( 0.20 , CI : 0.14–0.27 ) , respectively ( RR : 0.71 ; 95 % CI : 0.43–1.17 ) . A significant dose-response relation was observed between the adjusted quantity of enteral feeding and the risk of LOS , regardless of the type of feeding . Conclusion : For preterm infants , pasteurization of mother ’s own milk shows a trend towards an increase in infectious morbidity , although no statistical significance was reached . Practice s should focus on collection , storage and labeling procedures to ensure the safety and quality of expressed milk OBJECTIVE This study tested the hypothesis that feeding an exclusively human milk ( EHM ) diet  to premature infants reduces the incidence of necrotizing enterocolitis ( NEC ) associated with enteral feeding . STUDY DESIGN An observational study for infants born at less than 33 weeks of gestational age was performed in a single neonatal intensive care unit . An EHM diet prospect ively eliminated bovine-based artificial milk , including bovine-based fortifier , through 33 weeks postmenstrual age ( PMA ) . The clinical data from a 2.5-year interval of the EHM diet were compared with data from the previous 6.5 years for similar infants who received bovine-based milk products  before 33 weeks PMA . RESULTS In the EHM diet cohort , 148 of 162 infants ( 91 % ) received EHM through 33 weeks PMA . In order to achieve an EHM diet , 140 of 162 infants ( 86 % ) received their own mother 's milk , and 98 of 162 infants ( 60 % ) received donor human milk . The EHM cohort was also fed a human milk-based fortifier to truly eliminate bovine products . The distribution of NEC onset in the EHM cohort was significantly different from that in the control cohort for the day of onset ( p=0.042 ) and the PMA at onset ( p=0.011 ) . In the control cohort , NEC onset after Day 7 of life occurred in 15 of 443 infants ( 3.4 % ) , significantly more than in the EHM cohort where NEC occurred in two of 199 infants ( 1 % ) ( p=0.009 ) . CONCLUSIONS Changing to an EHM milk diet through 33 weeks PMA reduced the incidence of NEC associated with enteral feeding BACKGROUND Retinopathy of prematurity(ROP ) is the most common serious ophthalmic disease in preterm infants .  Human milk may provide a protective effect for ROP ; however , beneficial effects of human milk preclude r and omized trials . Therefore , we conducted a retrospective analysis comparing early postnatal nutrition with ROP development . OBJECTIVE Evaluate relationship between early postnatal nutriture and ROP surgery . DESIGN / METHODS Nutrition data was collected for inborn AGA infants , BW 700 - 1000 g.  ROP surgery was the primary outcome variable . A single pediatric ophthalmologist supervised examinations . All infants received triweekly IM vitamin A as chronic lung disease prophylaxis ( Tyson : NEJM , 1999 ) . RESULTS  BW and gestational age were 867+/-85 g and 26.3+/-1.2 weeks ( n=77 , mean+/-1SD ) . ROP surgery infants(n=11 ) received more parenteral nutrition , 1648 mL , and less human milk , 13.8 mL/kg-day , and vitamin E , 1.4 mg/kg-day , during the second postnatal week . Human milk was a negative predictor for 
    Output:
    