Donated human milk use and subsequent feeding pattern in neonatal units

Abstract

Background Donated human milk (DHM) is a safe alternative in the absence of mother’s own milk (MOM); however, specific clinical indications for DHM use and its impact on subsequent feeding practice remain unclear. We aimed to audit local DHM use and explore the impact of the introduction of DHM as the first enteral feed on subsequent MOM availability. Methods We retrospectively audited DHM recipients nursed in Royal Hospital for Children, Glasgow from 2014 to 2016 against local guidelines. Data were collected from an operational electronic database. Descriptive data analysis was performed to describe DHM use. To explore the association between the first human milk feed with subsequent MOM availability Kruskal Wallis test was used. Adjustments for confounding variables were performed using analysis of variance (ANOVA). Results A total of 165 recipients of DHM (5.3% of all admission to RHC) were identified. The majority of recipients (69%) were born < 32 weeks of gestation. The main indication for DHM was prematurity, other indications included congenital anomalies of bowel and heart. The local guideline was adhered to in 87% of cases. The median interquartile range (IQR) at DHM introduction was 6 days (3, 17) and the duration of use was 12 days (6, 22). In those born < 32 weeks of gestation the type of human milk (DHM and/ or MOM) used as first feed did not influence the subsequent median IQR days of feeding with any MOM [DHM 40 (9, 51); MOM 28 (17, 49), MOM & DHM 17 (10, 26) p value = 0.465] after adjusting for birthweight and length of hospital stay. Conclusions In our unit, DHM is mainly used in preterm neonates in accordance with existing local guidance. Using DHM as first milk feed did not affect subsequent MOM availability. Electronic supplementary material The online version of this article (10.1186/s13006-019-0233-x) contains supplementary material, which is available to authorized users.

The Association Between Type of Supplementation in the Newborn Nursery and Breastfeeding Outcomes at 2 and 6 Months of Age

“…We were the first to compare longitudinal breastfeeding outcomes for infants cared for in the well newborn nursery and supplemented with MOM versus DHM during the birth hospitalization. A significant body of research exists regarding preterm and low birth weight infants’ receipt of MOM versus DHM (Alyahya et al, 2019; Parker et al, 2019), but no research exists for the healthy nursery population. One of our hypotheses was that the DHM group would be most similar to the MOM group with regards to duration of breastfeeding, since both groups were given only human milk during the birth admission.…”

Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

“…The accessibility of a human milk bank (HMB) could be an important factor associated with initiating ETF. The benefits of implementation of an HMB in NICUs have been reported by several studies ( Table S1 ) [ 22 , 23 , 24 , 25 , 26 ]. To date, seldom studies report the influence on growth outcome of these very preterm infants after the implementation of an HMB in NICUs.…”

Breastfeeding patterns in cohort infants at a high-risk fetal, neonatal and child referral center in Brazil: a correspondence analysis

“…3 National School of Public Health (FIOCRUZ), Rio de Janeiro, Brazil. 4 Global Network of Human Milk Banks (FIOCRUZ), Rio de Janeiro, Brazil.…”

“…The several benefits of breastfeeding for women's and children's health as well as short-and long-term economic and environmental benefits to the nation [1] are recognized, and cover populations living in high-, middle-and low-income countries [2]. They apply to both healthy and high-risk children [3,4]. Despite the available evidence, overall breastfeeding rates remain well below international goals, of at least 50% by 2025 [1,5,6].…”