What is intraventricular hemorrhage?
Intraventricular hemorrhages, or brain bleeds, happen when there is bleeding within the brain’s ventricular system. IVH can result from oxygen deprivation at birth (associated with hypoxic-ischemic encephalopathy) or trauma during birth. Infants who are born prematurely or at a low birth weight are particularly susceptible to brain bleeds because they tend to have weaker blood vessels. Roughly 12,000 premature babies develop intraventricular hemorrhage every year in the U.S. (3). It is especially common in infants born very premature, occurring in about 45% of neonates born extremely premature and weighing between 500 and 750 g (infants weighing less than 1500g are considered very low birth weight, or VLBW).
It makes sense, then, that IVH remains a common complication in NICUs across the country. Studies of intranasal application of neuroprotective substances and Erythropoietin therapies have shown positive outcomes, but require more human studies to confirm.
Why intranasal breast milk?
The benefits of breast milk have been proven far and wide, with breast milk shown to contain human stem cells and neurotrophins, proteins that encourage the growth and development of neurons. Nasal breast milk exposure has not been investigated to date. However, it has been found in animal studies that medications administered intranasally are able to reach the brain without entering the bloodstream (4).
The thought behind the study
Researchers studied newborns born in-hospital at one particular neonatal intensive care unit (NICU). In 2012, one VLBW newborn who suffered severe IVH was delivered regular drops of breast milk from her mother intranasally out of compassionate use (meaning her parents agreed to this treatment based on the known neurotrophins and stem cells in breastmilk and the potential for nasal administration to increase the brain’s exposure to them) (2). The infant was also feeding with her mother’s breast milk. Intranasal administration of breast milk is commonly used for neonatal nasal congestion, so safety concerns were not present.
One drop of the mother’s breast milk was administered to the nasal cavity three times daily for 10 weeks. The intraventricular hemorrhage resolved over 7 weeks and the baby was discharged at 10 weeks with good neurological outcomes (2). This positive outcome encouraged neonatologists to pursue the same treatment in 15 other VLBW neonates with severe IVH between July 2012 and August 2014 with informed permission from their parents.
Thirty-nine VLBW infants were born with severe IVH grade 3 or 4 during this time period (2). Of these infants, three died within the first three days, and five did not receive breast milk for maternal reasons. Thirty-one received breast milk feeding. Fifteen of these infants were in the control group, not receiving intranasal breast milk drops, and 16 were in the intervention group, receiving intranasal breast milk drops. The milk used was their own mother’s milk in every case, given within two hours of expression, started within the first five days after birth, and continued for at least 28 days (2).
Researchers measured the results of this study with standard cerebral ultrasound. They found that (2):
- Incidence of surgery for posthemorrhagic hydrocephalus was lower in the intranasal breast milk group than in the control group.
- Incidence of progression ventricular dilation was lower in the intranasal breast milk group than in the control group.
Their research suggests that nasal exposure to the mother’s breast milk contributes to better delivery of neuroprotective substances in breast milk to the brain (2). This study is small, and the research is still in the early, experimental stages, however. Further controlled studies are required to prove that intranasal breast milk administration benefits infants with brain injuries.
ABC Law Centers: Legal Help for Intraventricular Hemorrhages
If you are seeking legal help for a baby that had an intraventricular hemorrhage, it is very important to choose a lawyer and firm that focus solely on birth injury cases. ABC Law Centers (Reiter & Walsh, P.C.) is a birth injury firm that has been helping children throughout the nation for over three decades.
We have helped families obtain compensation for lifelong treatment, therapy, and a secure future, and we give personal attention to each child and family we represent. Our firm has numerous multi-million dollar verdicts and settlements that attest to our success, and clients pay nothing until we win their case. Please reach out today for a free case evaluation.
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- How Does Intraventricular Hemorrhage (Brain Bleed) Relate to HIE?
- What are the Long-term Effects of Brain Hemorrhages?
- Erythropoietin/Hypothermia Therapy in Combination: Potential New Treatment for HIE?
- Wisner, W. (2019, August 23). Scientists Have Discovered That Breastmilk May Help Preemies With Brain Injuries. Retrieved from https://www.scarymommy.com/nasal-application-of-breastmilk-protect-preemies/?utm_content=buffer086f1&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
- Keller, T., Körber, F., Oberthuer, A., Schafmeyer, L., Mehler, K., Kuhr, K., & Kribs, A. (2019). Intranasal breast milk for premature infants with severe intraventricular hemorrhage-an observation. European journal of pediatrics, 178(2), 199–206. doi:10.1007/s00431-018-3279-7
- Ballabh P. (2010). Intraventricular hemorrhage in premature infants: mechanism of disease. Pediatric research, 67(1), 1–8. doi:10.1203/PDR.0b013e3181c1b176
- (2019, February 14). Can intranasal application of breastmilk cure severe IVH? Retrieved from http://www.allthingsneonatal.com/2019/02/14/can-intranasal-application-of-breastmilk-cure-severe-ivh/?fbclid=IwAR34kzJZG6fK2CxlCI5bCrv3utLrVJmgXuZiQX29amc-C9M1XN9GUKHzyPQ