CMV Infections from Breast Milk

CMV Infections from Breast Milk

Miron D, Brosilow S, Felszer K, et al. Incidence and Clinical Manifestations of Breast Milk-Acquired Cytomegalovirus Infection in Low Birth Weight Infants. J Perinatology (May 2005) 25: 299-303.

OBJECTIVES: To determine the incidence and clinical manifestations of human breast milk (HMB)-associated acquired cytomegalovirus (CMV) infection in small premature infants.

STUDY DESIGN: A prospective study of premature infants born at or prior to 32 weeks gestation, and or infants weighing 1500 g or less at birth. The babies were divided into two groups: Group 1 included babies of CMV seropositive mothers who received HBM throughout the study period. Group 2 included babies of seronegative mothers or babies that did not receive HBM at all. Urine sample were obtained once weekly from birth until the age of 8 weeks or until discharge and were tested for the presence of CMV-DNA by PCR.

RESULTS: Four of 70 infants from group 1 (5.7%, 95% CI, 0 to 11%) acquired CMV infection between the ages of 3 and 7 weeks as compared to none of 26 babies in group 2. Only one infected baby had severe CMV disease with complete recovery.

CONCLUSION: The relative incidence of HBM-associated CMV infection and the severity of HBM-associated CMV disease in premature infants are low.

Comments. In an accompanying editorial, Dr Richard Schanler points out that the reported rate of CMV acquisition in infant’s fed their seropositive mother’s milk in this study (5.7%), is not significantly different that from the rate of CMV acquisition reported in other studies for premature infants fed seronegative mother’s milk or formula (0-11%). It appears from available data that the risk in premature infants of acquiring a serious CMV infection from ingesting fresh mother’s milk is minimal, and that the potential benefits of using fresh breast milk outweigh the risks. Freezing of the milk before use may decrease (but does not eliminate) the risk of CMV transmission. ABK.

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