Tuesday, August 16, 2016
Impact of donor human milk vs. infant formula on premature infant outcomes
Mother’s milk is important for infants, particularly very low-birth-weight (VLBW) infants. The benefits of feeding mother’s milk compared with formulas to a premature infant include the decreased rate of comorbidities such as necrotising enterocolitis (NEC), improved feeding tolerance, shorter hospital stay, and improved developmental outcomes. A review article published in the journal Current Opinion in Paediatrics reported the usage and outcomes of donor human milk in VLBW infants.
The use of donor human milk is rapidly gaining acceptance. The rates of donor human milk usage in the United States have increased from 21.2% in 2007 to 30.8% in 2011. According to the directors of neonatal intensive care units (NICUs) in the United States, 62% of donor human milk was used in the west, 47% in the mid-west, 36% in the south, and 23% in the north-west. About 73% of the NICUs using donor milk followed specific guidelines, and 84% of them obtained parental consent. Furthermore, there was high parental acceptance for the usage of donor milk.
In NICUs, the usage of donor milk increased with the increase in the admission of VLBW infants. Reducing the occurrence of NEC in VLBW infants was the most important reason cited by doctors, for the usage of donor human milk. However, there is limited evidence on the protection offered by donor human milk against NEC in infants. Additional fortification and protein supplementation may be necessary for VLBW infants, in order to achieve optimum growth.
Several randomised trials based on donor milk compared to premature infant formula in VLBW infants are in progress in North America. These trials will investigate the neurodevelopmental outcomes of VLBW infants receiving donor milk compared to those receiving formula. Further research is required to confirm the use of donor human milk as the standard care for VLBW infants.
News source - Colaizy TT. Donor human milk for very low birth weights: patterns of usage, outcomes, and unanswered questions. Current opinion in pediatrics. 2015 Apr; 27 (2):172–6.