Short outcomes of donor milk and mother's own milk for preterm infants.

BACKGROUND

When MOM is unavailable, Donor Human Milk (DHM) is proposed, however, there is still insufficient evidence to determine whether DHM has similar benefits to MOM. This study aims to determine the relationship between DHM intake and MOM with short-term outcomes in preterm infants, hospitalized in Neonatal Intensive Care Units (NICU).

METHODS

This prospective cohort study was conducted in October 2023 to December 2024 on preterm infants aged less than 32 weeks, who were hospitalized in NICU of selected hospitals of Isfahan University of Medical Sciences, Iran. Participants consisted of 392 preterm infants who were assigned into two groups receiving DHM > 70% (n = 140) and MOM > 70% (n = 252). Primary and secondary outcomes were monitored and recorded by the researcher during the preterm infant's hospitalization in the intensive care unit until discharge.

RESULTS

Results showed that the incidence of Metabolic Bone Disease (MBD) was not significantly different in the two groups (OR = 1.31, 95% CI: 0.70-2.47, p = 0.395). Osteopenia of prematurity (OR = 0.79, 95% CI: 0.27-2.33, p = 0.665), and Necrotizing Enterocolitis (NEC) (OR = 0.88, 95% CI: 0.35-2.20, p = 0.789), both showing no significant differences. Positive blood culture (OR = 0.54, 95% CI: 0.22-1.33, p = 0.179), indicating a non-significant lower risk in the DHM group. In contrast, Bronchopulmonary Dysplasia (BPD) showed a significantly higher risk in the DHM group (OR = 2.01, 95% CI: 1.22-3.29, p = 0.006). Total Parenteral Nutrition (TPN) duration, achieving feeding volume of 120 ml/kg/days and full interal feeding were significantly shorter in the DHM group (p < 0.001).

CONCLUSIONS

These results identify that BPD was significantly more common in the DHM group than in the MOM group. Holder pasteurization may lead to the removal of anti-inflammatory factors in MOM and increase the incidence of BPD in preterm infants receiving DHM.

IMPACT

The popularity of using DHM as standard nutritional care in neonatal intensive care units is increasing To our knowledge, this is one of the few cohort studies exploring short-term outcomes of preterm infants in MOM and DHM fed groups until discharge Initiation, duration, and volume of feeding of preterm infants with DHM are one of the strengths points of this study, which provides valuable clinical application in the nutrition of preterm infants There is a need for the development of public policy to increase both the access to DHM and awareness regarding its beneficial effects, especially amongst populations with low breastfeeding rates.