Although the use of fortified mother's milk (FMM, mother's own milk plus supplemental protein, minerals, and vitamins) for feeding premature infants is increasing, it is a difficult process for the mothers and may become costly. However, with less morbidity and shorter hospitalization cost becomes less relevant. The primary hypothesis of this study is that FMM protects the premature infant from late-onset sepsis and/or NEC and shortens the duration of hospitalization compared with the feeding of preterm formula because it provides specific functional antibody against common pathogens in the neonatal environment. Secondary hypothesis [sic] that will be tested are: 1) The improved health but slower growth tof the FMM fed compared with the formula-fed premature infant continues beyond hospitalization; and 2) Insufficient milk production is related to maternal stress which can be reduced by the common nursery practice of skin-to-skin contract between mother and infant. Premature infants less than 30 weeks (n = 272) will complete a study of the following specific aims: 1) To determine the incidence of sepsis and/or NEC and duration of hospitalization in both a randomized trial of feeding premature infants FMM supplemented either with fortified pasteurized donor human milk or preterm formula and in a non-randomized comparison of FMM and preterm formula; 2) To determine the relationship between specific functional antibody titers in serial milk samples the incidence of pathogen--specific sepsis (Staphylococcus epidermidis, Staphylococcus aureus), and to determine if specific nursery protocols, such as skin-to--skin contact between mother and infant affect the development of functional antibody in serum and milk; 30 To determine long-term sequelae (growth, body composition, health) of FMM versus formula feeding in premature infants, and 4) To determine the relationship between stress and milk production in mothers of premature infants, and 4) To determine the relationship between the effect of skin- to-skin contract as a stress reduction method.
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