Human cytomegalovirus (HCMV) can be transmitted through breast milk to neonates. Although
healthy full-term infants rarely develop symptoms of CMV infection; premature or
low-birth-weight infants can experience symptomatic infection that is occasionally severe.
There is limited information on the long-term effects of postnatal CMV infection in premature
infants, suggesting that these infants do not develop cognitive function delays or hearing
loss, although those with intrapartum infection do. Readily available methods of treating
breast milk to inactivate the CMV either diminish the immunologic and nutritive benefits of
breast milk or incompletely inactivate the virus.
This review considers the data on measuring CMV in breast milk, the recent clinical studies
on CMV transmission via breast milk, reported methods of inactivation of CMV in breast
milk, and immunologic factors that may play a role in transmission. CMV-IVIG treatment
needs further evaluation but appears promising. Recommendations are made to help address
the issue of CMV transmission to premature infants in clinical practice in the neonatal intensive
care unit (NICU).
