Review highlights the importance of donor human milk being available for very low birth weight infants

Abstract

One of the key roles of neonatal units is to support the growth and development of preterm infants during the critical period between birth and term equivalent age. Nutritional care is an important part in this process, as it is crucial that these vulnerable babies receive sufficient nutrients. Human milk makes a major contribution to this goal. It also has an indirect effect on growth and development, by alleviating the risk of complications due to premature birth. 1 Mother's own milk is the first choice for preterm infants, but some mothers find it difficult to produce and sustain enough milk to meet their infants' needs. A survey of 11 European countries showed that, on average, only 58% of very low birth weight (VLBW) infants received any breast milk at discharge and the rates ranged from 36% to 80%. 2 Donor human milk should be the second choice in such cases, as this provides VLBW infants with essential nutritional and bioactive components. It also minimises their exposure to cows' milk formulas, which have been associated with an increased risk of necrotising enterocolitis (NEC). 3

Association between Abnormal Antenatal Doppler Characteristics and Gastrointestinal Outcomes in Preterm Infants

“…According to their findings, different timings of enteral feeding introduction failed to effectively modify GI outcomes, whereas the use of exclusive breast milk during enteral feeding advancement significantly reduced the risk of FI and NEC. This is in line with the multiple protective effects of human milk and with the well-established negative role of formula feeding in NEC development, as extensively documented by longstanding evidence [ 37 , 38 , 39 , 40 , 41 ] and further confirmed by the present results. Hence, our findings highlight how the combination of increasing prematurity and placental vascular dysfunction with the following compromise of fetal hemodynamics significantly amplify the risk of adverse GI outcomes.…”

A systematic review of contaminants in donor human milk

“…DHM improves rates of MOM at discharge (Shenker et al, 2023) and reduces the consumption of formula milk, a well‐known risk factor for NEC in preterm infants (Picaud, 2022). The United States Food and Drug Administration states that systematic reviews of powdered infant formula report a relatively high contamination rate (2%–15%) of Cronobacter species (NACMCF, 2022).…”

Evaluation of Intestinal Microbial Metabolites in Preterm Infants with Different Initial Feeding Methods by In Vitro Fermentation Modeling System

“…From February 2019, all the preterm infants less than 1500 g could be fed with human milk, which including mother’s own milk and DHM, even in the first few days, after we established our human milk bank. Many studies have shown that compared with formula milk, DHM can improve the feeding tolerance of infants, reduce the incidence of infection, NEC, BPD, and retinopathy of prematurity (ROP) [ 10 ] and reduce readmission and the risk of adolescent cardiovascular disease. Although pasteurization destroyed some components in DHM, the loss of nutrients was very small.…”