Impact of Intranasal Administration of Fresh Breast Milk in Very Low Birth Weight Infants With Germinal Matrix-Intraventricular Hemorrhage

There are no specific treatment modalities that prevent the progression of germinal matrix and intraventricular hemorrhage (GM-IVH) once it occurs. Breast milk is rich in mesenchymal stem cells, extracellular vesicles, and neurotrophins, all of which have been shown to have therapeutic effects. Intranasal drug administration has been demonstrated to be a reliable method for delivering various therapeutic agents directly to the brain via the olfactory nerve pathway. In this study, we aimed to evaluate the neuroprotective role of intranasal breast milk in very low birth weight (VLBW) infants with GM-IVH by assessing ventricular dilation and GM-IVH size on ultrasound, as well as neurodevelopmental outcomes using the Bayley-III scale. This study included 22 VLBW infants diagnosed with GM-IVH in the first postnatal week. A total of 11 infants received intranasal breast milk (inFBM) for at least 28 days or until discharge, while 11 infants in the control group received standard treatment. Patients were clinically monitored via cranial transfontanelle ultrasonography. A total of 14 patients from both groups were evaluated using the Bayley-III Infant Developmental Screening Scale. The incidence of posthemorrhagic ventricular dilation (PHVD) was significantly lower in the study group than in the control group (p = 0.010). In addition, the incidence of grade regression in the transfontanelle ultrasonography findings at discharge was significantly greater in the study group than in the control group (p = 0.008). Moreover, the incidence of retinopathy of prematurity was lower in the study group than in the control group. Compared with non-administration, the intranasal administration of fresh breast milk to VLBW premature infants with GM-IVH results in regression of GM-IVH and significantly reduces progression to posthemorrhagic ventricular dilation. It may also reduce the incidence of retinopathy of prematurity.