

* Division of Neonatal-Perinatal Medicine, Schneider Children's Hospital at North Shore, North Shore University Hospital, Manhasset, New York
Albert Einstein College of Medicine, Bronx, New York
Sections of Neonatology
|| Pediatric Gastroenterology
¶ Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
Objective. Compared with preterm formula (PF), mother's milk (MM) is associated with lower rates of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) among premature infants. Because not all mothers of premature infants produce sufficient milk to supply their infants throughout hospitalization, we reasoned that pasteurized donor human milk (DM) would be a suitable alternative.
Methods. Extremely premature infants (<30 weeks of gestation) whose mothers intended to breastfeed were assigned randomly to receive either pasteurized DM or PF if the supply of their own MM became insufficient during the study (birth to 90 days of age or hospital discharge). Infection-related events (LOS, NEC, meningitis, presumed sepsis, or urinary tract infection) that occurred after the attainment of a milk intake of 50 mL/kg, dietary intake, growth, skin-to-skin contact, and duration of hospital stay were compared. The primary analysis compared groups DM and PF on an intent-to-treat basis. If no differences were noted, then these groups were combined and compared with the reference group, group MM. If differences were noted, then the subsequent analyses compared each group with group MM.
Results. Of 243 infants, 70 (29%) received only MM; group DM included 81 infants and group PF included 92 infants. Because of poor weight gain, 17 infants (21%), all in group DM, were switched to PF. There were no differences in birth weight, gestational age, multiple births, and age at attainment of feeding of 50 mL/kg among groups. There were no differences between group DM and group PF in LOS and/or NEC, other infection-related events, hospital stay, or number of deaths. Group DM received a greater intake of milk and more nutritional supplements but had a slower rate of weight gain, compared with group PF. Compared with groups DM and PF, group MM had fewer episodes of LOS and/or NEC and total infection-related events and a shorter duration of hospital stay. Group MM also had fewer Gram-negative organisms isolated from blood cultures than did the other groups.
Conclusions. In this randomized, blinded trial of feeding of extremely premature infants, we found that, as a substitute for MM, DM offered little observed short-term advantage over PF for feeding extremely premature infants. Advantages to an exclusive diet of MM were observed in terms of fewer infection-related events and shorter hospital stays.
Key Words: human milk pasteurized human donor milk premature infant feeding
Abbreviations: DM, donor human milk PF, preterm formula MM, mother's milk LOS, late-onset sepsis NEC, necrotizing enterocolitis ROP, retinopathy of prematurity OR, odds ratio CI, confidence interval
This article has been cited by other articles:
![]() |
T. D. Soltau and R. L. Schelonka Immune Modification to Prevent Nosocomial Sepsis in Hospitalized Newborns NeoReviews, May 1, 2008; 9(5): e199 - e205. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. L. Patel, P. P. Meier, and J. L. Engstrom The Evidence for Use of Human Milk in Very Low-birthweight Preterm Infants NeoReviews, November 1, 2007; 8(11): e459 - e466. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. P. Meier and J. L. Engstrom Evidence-based Practices to Promote Exclusive Feeding of Human Milk in Very Low-birthweight Infants NeoReviews, November 1, 2007; 8(11): e467 - e477. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. D. Heller, M. O'Shea, Q. Yao, J. Langer, R. A. Ehrenkranz, D. L. Phelps, W. K. Poole, B. Stoll, S. Duara, W. Oh, et al. Human Milk Intake and Retinopathy of Prematurity in Extremely Low Birth Weight Infants Pediatrics, July 1, 2007; 120(1): 1 - 9. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. S. Cohen Current Issues in Human Milk Banking NeoReviews, July 1, 2007; 8(7): e289 - e295. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. F Williams, C. C Kingdon, and G. Weaver Banking for the future: investing in human milk Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F158 - F159. [Full Text] [PDF] |
||||
![]() |
C. A Boyd, M. A Quigley, and P. Brocklehurst Donor breast milk versus infant formula for preterm infants: systematic review and meta-analysis Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2007; 92(3): F169 - F175. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. J Schanler Evaluation of the evidence to support current recommendations to meet the needs of premature infants: the role of human milk Am. J. Clinical Nutrition, February 1, 2007; 85(2): 625S - 628S. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. Modi Donor breast milk banking BMJ, December 2, 2006; 333(7579): 1133 - 1134. [Full Text] [PDF] |
||||
![]() |
E. Bertino, F. Giuliani, P. Tonetto, C. Fabris, C. Profeti, C. Magnani, G. E. Moro, and S. Arslanoglu Randomized, Controlled Trial of Breastfeeding Versus Formula Feeding in Extremely Low Birth Weight Infants Pediatrics, March 1, 2006; 117(3): 985 - 986. [Full Text] [PDF] |
||||
![]() |
N. E. Wight Donor Milk: Down but Not Out Pediatrics, December 1, 2005; 116(6): 1610 - 1610. [Full Text] [PDF] |
||||