Post-natal transmission of cytomegalovirus (CMV) through breast milk is a frequent occurrence given that approximately 50% of adults are carriers of CMV. Symptomatic postnatal CMV infection is rare in term infants, likely because of maternal antibody transfer in the third trimester. A recent meta-analysis found wide variation among studies with overall mean rate of CMV transmission via breast milk 23%, mean risk of symptomatic CMVทinfection 3.7% and mean risk of sepsis-like symptoms of 0.7% with most symptomatic infections in premature infants.Low birth weight and early transmission after birth are risk factors for symptomatic disease.Whether CMV infection increases the severity of the diseases of prematurity (e.g. chronic lung disease, NEC, periventricular leukomalacia) is unknown. Long term studies of premature infants infected with CMV through mother’s own milk are few, but suggest that hearing loss and severe neurodevelopmental delays are uncommon. Pasteurization inactivates CMV; freezing may decrease but does not eliminate transmission of CMV.There is no consensus among neonatologists and pediatricians regarding the best balance between the benefits of human milk and the risks of CMV infection. Recommendations vary from pasteurizing all human milk until corrected gestational age of 32 weeks, to screening all mothers who deliver preterm and withholding colostrum and pasteurizing milk of women who are CMV IgG positive, to freezing all CMV positive milk for premature infants < 32 weeks.