Background: Mother's own milk (MOM) is considered the optimal nutrition for preterm infants. Unfortunately, MOM can contain human cytomegalovirus (HCMV), which can be transmitted to the infants. Postnatal HCMV infection in very preterm infants can lead to organ failure. Clinical Findings: In this case we report cholestasis possibly associated to HCMV transmitted through MOM in a very growth-restricted extremely preterm infant. Primary Diagnosis: The primary diagnosis is postnatal HCMV infection. Interventions: The infant was too preterm to be treated with antiviral medication. Instead, he was treated with a diet with no fresh MOM but only freeze-thawed MOM to reduce the viral load. Outcomes: Conjugated bilirubin values normalized after the infant was fed freeze-thawed MOM with a reduced viral load and formula. Practice Recommendations: The awareness of HCMV-positive mothers giving birth to extremely preterm infants should be increased. Feeding only freeze-thawed MOM or in combination with fresh MOM should be considered prophylactically to avoid transmission of high viral loads of HCMV to these vulnerable infants.
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