Pasteurised donor human milk audit: What is happening in the neonatal critical care unit?

Abstract

Aim Human milk with fortification, providing additional energy, protein and micronutrients, is considered the optimal form of nutrition for preterm infants as it provides protection against infections and improves outcomes. Mothers' own milk (MOM) is the preferred choice, however in situations where MOM is insufficient or contraindicated; Pasteurised donor human milk (PDHM) is the preferred alternative. This study aimed to identify whether PDHM during neonatal critical care unit (NCCU) admission is associated with discharge nutrition in preterm infants. Methods A retrospective observational cohort study was conducted over a 12‐month period in 2017. This included all inborn infants admitted to the NCCU with gestational age ≤ 28 weeks or ≤ 1000 g birthweight, who survived until discharge. Multivariate logistic models were used to detect the association between study groups (PDHM vs. No PDHM) and discharge nutrition. Results Seventy‐seven infants were included; 35 infants received PDHM during admission. At discharge, infants who received PDHM were significantly more likely to be on infant formula (IF) (86%) than infants who did not receive PDHM (26%). In contrast, infants who did not receive PDHM (No PDHM) were significantly more likely to be receiving MOM exclusively at discharge (74%), than those who did receive PDHM (14%). The odds of an infant being discharged on IF were 16.91 times higher if they received PDHM. Conclusion In this study, infants born at ≤28 weeks or ≤ 1000 g who received PDHM were more likely to receive IF at NCCU discharge than infants who did not receive PDHM.

Preterm birth and human milk proteome: are we ready for individualized fortification?

“…Fresh breast milk is the best source of naturally occurring immunoglobulins, which inhibit harmful bacterial colonization in the infant's gut and promote effective absorption of nutrients, all together resulting in gut maturity [42]. Donor milk is considered the next best choice despite its reduced anti-inflammatory benefits when mother's own milk is not available [43]. However, Zhu et al [44] confirmed that the protein and endogenous peptide composition of human milk were highly personalized.…”