The policy in the unit where I work is that mother's milk given to premies
less than 34 weeks must be frozen for 24 hours first. Once baby goes to
breast, however, they may receive fresh milk. So--guess what one of our goals
is? We try get premies to breast as soon as possible.  We let small babies
lick a few drops from mom and then they can have fresh milk forever more.
Our neonatologists won't budge on the 34 week cutoff, but they also won't go
so far as to prevent premies less than 34 weeks from going to breast. In fact
we have no policy stating when breastfeeding can start so we evaluate each
baby individually .  Nothing about this 34 week policy makes much sense since
we are able to partially circumvent it, but we take our baby steps wherever
we can. Whenever I go to a conference re Bfdg and premies I ask the CMV
question and the neonatologist speaking invariably hedges.  Since the
consequences of a premie getting CMV are pretty bad I know it is important to
weigh the risk vs benefits of fresh milk.  The consequences of NEC are also
pretty dire so I would love to see an analysis of the risks vs benefits of
fresh milk for very low birth wt. babies. My gut feeling (pardon the pun) is
that the benefits of fresh milk outweighs the very small but real risk of
transmission of CMV.

Anyone with any data on this?  Also, freezing doesn't always kill all of the
CMV.  And, no, we don't test our moms.

Kathy Boggs, RN, IBCLC

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