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The American Academy of Pediatrics [17] recommends human milk for preterm and other high-risk infants either by direct breastfeeding or using the mothers own expressed milk. Banked pasteurized human milk is suggested to be a suitable feeding alternative. Decisions about breastfeeding of very low birth weight infants by mothers known to be HCMV-seropositive should be made with caution, weighing the potential benefits of human milk versus the risk of HCMV transmission. The Committee for Nutrition of the Austrian Society of Paediatrics and Adolescent Medicine [16] recommends determining the HCMV serostatus of every mother and, in the case of HCMV-IgG-positivity, the colostrum has to be abandoned and breast milk has TRIB1 to be pasteurized before being fed. This procedure is suggested for the infant up to the corrected gestational age of 35?weeks. The French Society for the Safety of Nutrition [18] restricts the feeding of raw breast milk to preterm infants above 32?weeks of gestation (above 1500?g). The guidelines of the Swedish National Board of Health and Welfare recommend the freezing of HCMV positive maternal milk for preterm babies PI3K inhibitor neutrophils and lymphocytes in breast milk, which should ensure both a specific and a nonspecific antiviral defence. In view of the biological and nutritional value of breastfeeding, this transmission route should be interpreted as a positive factor [58]. Three decades later, we still share the view of Stagno et?al. [8] that the minimal risk associated with the transmission of HCMV through breast milk is clearly outweighed by the well-established value of breastfeeding. Summarizing the results of our review, the mean www.selleckchem.com/products/pci-32765.html rate of HCMV transmission was 22.8%, the mean risk of symptomatic disease was 3.7%, and that of sepsis-like symptoms was 0.7%. The question remaining is whether the low risk of severe symptomatic disease justifies withholding colostrum and breast milk feeding from all preterm infants below 32?weeks of gestation. Do we trade the benefits of human milk for the slight chance of ��clinical deterioration�� [59]? In our opinion, an individual decision, based on the health status of the preterm infant, should be preferred to a general approach. The authors declare that there are no conflicts of interest.