Donor Human Milk for Premature Infants

Abstract

Human milk has many well-established health benefits for both term and premature infants. When mother’s own milk is unavailable, pasteurized donor human milk feeding has become a standard of care for sick and premature infants in many neonatal intensive care units. Significant data show that feeding premature infants pasteurized donor human milk in the absence of mother’s own milk reduces the risk of developing necrotizing enterocolitis when compared with feeding infant formula. However, there is also substantial evidence that premature infants have slower growth rates in the immediate neonatal period when fed donor milk rather than infant formula or mother’s own milk. The composition of human milk is significantly affected by stage of lactation and the pasteurization process, and the substantial nutritional differences between mother’s own milk and pasteurized donor milk must be considered when using donor milk as a source of long-term nutrition for premature infants. Close attention to fortification methods and nutrient provision is needed when attempting to meet the nutrition needs of the premature infant with donor milk. Feeding protocols should be established that allow for provision of human milk to the most vulnerable preterm infants regardless of availability of mother’s own milk, while at the same time minimizing the risk of inadequate nutrition.