Language
English
Publication Date
1-1-2025
Journal
Journal of Pediatric Gastroenterology and Nutrition
DOI
10.1002/jpn3.12403
PMID
39526563
PMCID
PMC11863988
PubMedCentral® Posted Date
1-1-2026
PubMedCentral® Full Text Version
Author MSS
Abstract
Objectives: Human milk intake has many benefits which could influence outcomes in biliary atresia (BA). However, the role of human milk in BA has not been examined. We hypothesized that human milk intake would be associated with improved outcomes in BA.
Methods: We assessed the impact of any human milk (AHM) as compared to formula only (FO) intake before Kasai portoenterostomy (KP) on outcomes in 447 infants with BA using the PROBE database (NCT00061828) post hoc. The primary outcome was clearance of jaundice (COJ = total bilirubin (TB) < 2 mg/dL by 3 months post-KP). Secondary outcomes included 2-year survival with native liver (SNL), bilirubin levels, cholangitis, ascites, and growth. We assessed the fecal microbiome (n = 8) comparing AHM versus FO.
Results: At baseline, 211 infants received AHM and 215 received FO. 53.9% of AHM and 50.5% of FO achieved COJ (p = NS). SNL was insignificantly increased in AHM (odds ratio = 1.47, 95% confidence interval: 1.00-2.12, p = 0.053). TB decreased in AHM from 4 weeks to 3 months post-KP [4.8-4.0 mg/dL (p = 0.01)] unlike the FO group (4.9-4.9 mg/dL, p = 0.4). At 3 months post-KP, AHM infants had greater weight gain (1.88 ± 0.66 vs. 1.57 ± 0.73 kg, p < 0.001) and mid-upper arm circumference (12.9 ± 1.4 vs. 12.2 ± 1.7 cm, p < 0.001). Other secondary outcomes were not different. Microbiome differences were seen between AHM and FO.
Conclusions: Human milk intake in infants with BA did not significantly improve COJ or SNL. However, growth parameters were improved, and TB 3 months post-KP was decreased. Thus, human milk intake should not be discouraged. Prospective studies with detailed assessment of human milk intake are needed.
Keywords
Female, Humans, Infant, Infant, Newborn, Male, Biliary Atresia, Infant Formula, Milk, Human, Portoenterostomy, Hepatic, Treatment Outcome, Liver transplant, Cholestasis, Nutrition
Published Open-Access
yes
Recommended Citation
Tessier, Mary Elizabeth M; Schraw, Jeremy M; Beer, Stacey; et al., "The Association of Human Milk Intake and Outcomes in Biliary Atresia" (2025). Faculty, Staff and Students Publications. 6369.
https://digitalcommons.library.tmc.edu/baylor_docs/6369