ArticleArchives of disease in childhood. Fetal and neonatal edition2024
Case-control study of milk curd obstruction in newborn infants in a tertiary surgical neonatal intensive care unit.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMilk curd obstruction (MCO), in which milk becomes inspissated, is a rare, serious, complication of preterm birth. Case reports implicate male sex and bovine-derived human milk fortifier (HMF) use as predisposing factors. We investigated this through a case-control study.
methodsMCO cases in the Starship Child Health neonatal database between 2008 and 2020 were matched with controls in a 1:2 ratio based on gestational age (±1 week), birth weight (±200 g) and date of birth (±1 month). Data were analysed using the Student's t-test, Mann-Whitney U-test or χ² test as appropriate. Data are median (IQR) or n (%).
resultsOf 20 MCO cases, gestation was 26.1 (24.5-28.1) weeks, birth weight was 822 (713-961) g, 15 (75%) were male. 40 controls were well-matched for gestation (26.1 (24.8-27.9) weeks) and birth weight (849 (690-1066) g) but only 18 (45%) were male (p=0.05). MCO occurred at 21 (15-33) days; 6 (30%) cases died compared with 3 (7.5%) controls (p=0.06). HMF was commenced at 243 (150-309) hours in cases and 224 (172-321) hours in controls (p=0.95); full-fortification (manufacturer's recommended dose) was achieved in 8 (40%) cases and 27 (68%) controls (p=0.08). In cases, MCO occurred 10 (7-17) days after commencing HMF. Medically/surgically-managed gut pathology occurred in 7 (35%) cases prior to MCO but in no controls (p<0.001).
conclusionsOur data support male sex but not HMF use as a predisposition to MCO. Evidence of prior medical/surgical gut pathology may be a premonition for MCO; however, further research is required to confirm this.
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