Experience using donor human milk: A single‐center cohort study in Japan

Abstract

Background Donor human milk (DHM) became available in Japan when the first human milk bank was established in 2017. This study investigated the effects of DHM on enteral nutrition (EN) in very low birth weight (VLBW) infants in the single center in Japan. Methods Seventy‐six VLBW infants hospitalized between April 2017 and March 2020 at Showa University Hospital were included in the study. We retrospectively evaluated age (hours) at which EN was initiated and age (days) until complete feeding (EN > 100 mL/kg/day) was achieved. We compared the DHM and non‐DHM groups, or the early human milk (EHM) and non‐EHM groups. The EHM group was defined as those in which EN was initiated with the mother’s own milk or DHM within 12 h of birth. Results In 30 extremely low birth weight (ELBW) infants, EN was initiated at significantly earlier postnatal hours in the DHM group compared to those in the non‐DHM group. Complete feeding was achieved at significantly earlier ages in the EHM group after adjusting for gastrointestinal complications and gestational age. Additionally, the changes in body weight z‐scores from birth to term‐equivalent age were significantly greater in the EHM group after adjusting for exclusive breastfeeding and small for gestational age, compared to the non‐EHM group. Statistical significance was not noted in 46 subjects (birth weight, 1000–1500 g). Conclusion The use of DHM may contribute to earlier initiation and achievement of EN, resulting in greater early postnatal growth in ELBW infants in Japan.

Questionnaire survey on donor human milk programs targeting NICUs in Japan

“…Therefore, EN should be started immediately after birth during neonatal intensive care unit (NICU) admission to improve neonatal care. 6,7 The Japan Human Milk Bank Association was established in 2017, and the Japan Pediatric Society issued a policy statement on EN for preterm and VLBWIs in 2019, 5 leading to an increase in the number of NICUs using DHM. In 2021, DHM was used in 47 institutions for more than 360 infants.…”

“…In addition, early use of DHM is known to shorten the duration of parenteral nutrition and lead to better weight gain. Therefore, EN should be started immediately after birth during neonatal intensive care unit (NICU) admission to improve neonatal care 6,7 . The Japan Human Milk Bank Association was established in 2017, and the Japan Pediatric Society issued a policy statement on EN for preterm and VLBWIs in 2019, 5 leading to an increase in the number of NICUs using DHM.…”