Transitioning from the intrauterine environment to life outside the womb requires numerous physiological adaptations. Generally, by 37 gestational weeks, most babies are physically capable of making this adjustment. But, for those born too early and/or too small, this transition can be difficult and is often associated with serious health challenges.  In fact, the earlier in a pregnancy that babies are born, the more support that is needed for proper growth and development.  Although feeding mother’s milk to very-low-birth-weight infants can help protect against life-threatening complications, many mothers are unable to provide sufficient breast milk and require a supplement of either pasteurized donor milk or preterm formula.

Use of donor milk versus preterm formula as a supplement or bridge when mother’s milk is unavailable reduces the risk of the serious gastrointestinal disease, necrotizing enterocolitis.  The composition of donor milk differs from that of mother’s milk and infants fed with donor milk may exhibit slower growth during hospitalization. The long-term impact of nutrient-enriched donor milk on growth, body composition, or blood pressure is unknown.

A new study published in The Journal of Nutrition determined the effects of nutrient-enriched donor milk compared with preterm formula on growth, body composition, and blood pressure of children born preterm and very-low-birth-weight. The study was a follow-up of children at 5.5-y of age who participated in a randomized controlled trial evaluating the effect of nutrient-enriched donor milk or preterm formula fed as a supplement when mother’s milk was unavailable.  The researchers hypothesized that infants randomly assigned to receive supplemental nutrient-enriched donor milk compared with preterm formula would have reduced adiposity and body mass index z scores at 5.5 y of age.

There were no differences in growth, body composition, or blood pressure between the two feeding groups. According to senior author Deborah O‘Connor (University of Toronto) and colleagues, “This is the first randomized controlled study to use nutrient-enriched donor milk in a comparison after discharge and during early childhood. Given previous observations of slower in-hospital weight, length, and head circumference gains among donor milk-fed infants, these findings should reassure clinicians of the use of donor milk as a bridge to mother’s milk for very-low-birth-weight infants during initial hospitalization.” 

A corresponding editorial by Steven Abrams (University of Texas) also stresses the importance of human milk in the neonatal intensive care unit stating that, “There can be little doubt of the need to provide human milk, both mother’s milk and donor milk, as needed for all very-low-birth-weight infants.”

References McGee M, Unger S, Hamilton J, Birken CS, Pausova Z, Kiss A, Bando N, O’Connor D. Adiposity and fat-Free Mass of Children Born with Very Low Birth Weight Do Not Differ in Children Fed Supplemental Donor Milk Compared with Those Fed Preterm Formula. The Journal of Nutrition, DOI: https://doi.org/10.1093/jn/nxz234.

Abrams SA.  Long-Term Growth and Body Composition Consequences of Using Fortified Donor Milk or Preterm Formula for Very-Low-Birth-Weight Infants. TheJournal of Nutrition, DOI: https://doi.org/10.1093/jn/nxz264.

Images credit: canva.com

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