Breast Milk Enemas Improve Neonatal Outcomes in Premature Infants: JAMA

A recent study conducted at the Shengjing Hospital of China Medical University in Shenyang found that breast milk enemas may significantly improve the health outcomes of preterm infants by speeding up meconium evacuation and the initiation of full enteral feeding. The key findings of the study were published in the Journal of American Medical Association.

This study was conducted from September 1, 2019 to September 30, 2022 and included a total of 286 premature infants born between 23 and 30 weeks of gestation. The randomized, open-label clinical trial compared the effects of administering breast milk enemas against normal saline enemas 48 hours after birth. The primary measures of the study were the duration taken to complete meconium evacuation and the time to establish full enteral feeding. Additional factors such as the length of hospital stay, the weight of infants at discharge and the duration of total parenteral nutrition were also evaluated.

The results indicated a significant reduction in the time to clear meconium in the group that received breast milk enemas, averaging a decrease of 2.2 days when compared to the saline group. Also, infants in the breast milk group achieved full enteral feeding, approximately 4.6 days sooner than the infants who received saline enemas. The requirement for total parenteral nutrition similarly reduced by an average of 4.6 days in the breast milk group that potentially reduces complications associated with prolonged intravenous feeding.

The findings suggest that breast milk enemas could play a crucial role in the management of premature infants who are often susceptible to the complications due to delayed meconium passage and feeding issues. While the use of breast milk for enemas is a new approach, it appears to be safe and more effective than saline in these fragile patients. This could represent a pivotal step forward in neonatal care by offering a simple yet effective intervention that harnesses the natural properties of breast milk.

No significant differences were observed in other secondary outcomes, including safety metrics that further supports the potential of breast milk enemas as a feasible treatment option in neonatal care settings. The outcomes call for further studies to explore the effectiveness of this intervention across different gestational ages and to determine the long-term benefits of earlier meconium evacuation.

Reference:

Zheng, L., Gai, L., Wu, Y., Kong, C., Sun, F., Gao, J., Yuan, W., Liu, M., Jiang, H., Tuo, N., & Yang, F. (2024). Breast Milk Enema and Meconium Evacuation Among Preterm Infants. In JAMA Network Open (Vol. 7, Issue 4, p. e247145). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.7145