The Effects of Feeding Breast Milk at Different Temperatures on Newborns: A Systematic Review and Meta-Analysis

Abstract

Background:

Breast milk is the optimal source of nutrition for newborns, especially preterm infants, and its temperature during feeding may influence both physiological stability and clinical outcomes. Although individual studies suggest potential benefits of warmed milk, evidence remains inconsistent and has not been comprehensively synthesized.

Objective:

To systematically review and analyze the effects of administering breast milk at different temperatures on physiological responses, feeding tolerance, and clinical outcomes in newborns.

Methods:

This systematic review and meta-analysis followed the Cochrane Handbook (version 6.0) and PRISMA guidelines. A comprehensive search of nine databases (CINAHL, CENTRAL, Web of Science, PubMed, Scopus, ScienceDirect, ERIC, EBSCO, OVID) was conducted for studies published between 2010 and 2025 in English. Data extraction and risk of bias assessment were performed independently by two reviewers using RoB-2 and ROBINS-I tools. Meta-analyses were conducted using Stata 16.0, applying fixed- or random-effects models based on I² heterogeneity values.

Results:

Five studies involving 373 infants met the inclusion criteria. Meta-analyses revealed no statistically significant effects of breast milk temperature on heart rate, oxygen saturation, or body temperature at 5 or 30 minutes after feeding. A small short-term decrease in body temperature (5 minutes post-feeding) was noted in the intervention group, but this was not sustained. Time to achieve full enteral feeding was also not significantly different between groups. Heterogeneity was substantial for several outcomes (I² > 85%). Risk of bias ranged from low to serious across included studies.

Conclusions:

Current evidence indicates that administering breast milk at different temperatures does not produce clinically meaningful differences in short-term physiological parameters or clinical outcomes in newborns. Milk at room temperature, near-body temperature, or alternative warming methods appears to be equally well tolerated.