Infant feeding and criticality in children.

Only children who survived and whose mothers were enrolled in the parent trial and consented to follow-up were eligible; it is unclear whether more non-surviving children were in either feeding group. The analysed sample was small (138 children) and the study was powered only for a large effect (a 25% absolute reduction in moderate/severe PARDS), so smaller effects could be missed. Enrolled families were more likely to be non-Hispanic White, higher income, college graduate/postgraduate mothers, and had bronchiolitis or asthma, and fewer had baseline cognitive or functional impairment, creating participation bias. Feeding exposure relied on maternal recall, and the study did not have data on birth weight, daycare attendance, number of siblings or cigarette smoke exposure. The study compared only the first month of exclusive feeding, not longer feeding patterns, and cannot show that breast milk feeding caused any outcome because children also received other critical care treatments.

Supported by Rush University College of Nursing awards, a Medela Nursing Research Scholars Grant, and National Heart, Lung, and Blood Institute and National Institute of Nursing Research, National Institutes of Health grants U01 HL086622 and HL086649. Lauren R. Sorce is an elected member of the SCCM Executive Committee and SCCM President 2024-2025, and the paper states the research does not represent SCCM; Dr Asaro and Dr Curley report no conflicts related to this research.

Do not conclude that exclusive human breast milk feeding in the first month reduces illness severity or reliably speeds recovery in critically ill children. The study found no significant association with PRISM III-12 scores or PARDS severity, and the time-to-recovery finding was not statistically significant; it was also an observational study of children receiving other PICU treatments, so it cannot separate breast milk feeding from those treatments.