Cytomegalovirus (CMV) is a virus that persists lifelong in blood cells and approximately half of all adults are carriers. The virus can be reactivated in mothers during the lactation period and can be transmitted to the infant via breast milk.
In general, infections in term infants stay asymptomatic because of the transmission of protective maternal antibodies in the last trimester of pregnancy. Very preterm born infants cannot be protected by these antibodies and are therefore at higher risk for symptomatic CMV.
Although it is very unlikely, CMV can affect the clinical course of pre-existing diseases in preterm infants.
Nevertheless preterm infants benefit from mother’s milk so that several experts still recommend breastfeeding for CMV-positive mothers. Pasteurisation is effective in deactivating the virus in breast milk and can also be a solution for preterm infants. It is recommended, that CMV-positive mothers and healthcare professionals discuss together the best solution based on the health status of the baby.
When providing milk is not possible
If mothers cannot provide enough milk, they should discuss alternative feeding options with a healthcare professional or a lactation specialist. Some guidelines recommend to express milk more often or to place warm compresses around the breast before milk expression. Specialists can also teach how to massage the breasts to intensify the blood circulation and activate milk ejection reflex. In addition, kangaroo care or any skin-to-skin contact will support mothers to provide more milk to their babies.
In case of insufficient breast milk, the milk can be supplemented with donor milk from an established human milk bank which follows specific safety guidelines or a preterm infant formula.A human milk bank collects, screens, stores, processes and distributes donor breast milk. Women donating milk will require a series of screening tests to make sure that they are physically healthy.