Neonatal Weight Gain on Minute or Large Amounts of Donor Milk

Abstract

Madore et al 1 Madore L.S. Bora S. Erdei C. et al. Effects of donor breastmilk feeding on growth and early neurodevelopmental outcomes in preterm infants: an observational study. Clin Ther. 2017; 39: 1210-1220 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar report that supplementing preterm infants with predominantly donor milk (DM) is associated with lower weight gain (g/kg/d) in the first 30 days of life compared with infants fed predominantly mother's own milk or preterm formula. This difference did not persist beyond 30 days of life. This was the only study to analyze growth in DM-fed infants at such an early time point. Two months later, we published a paper on growth of DM-fed infants in the first 28 days, with dissenting results. 2 Ginovart G. Gich I. Gutiérrez A. Verd S. A fortified donor milk policy is associated with improved in-hospital head growth and weight gain in very low-birth-weight infants. Adv Neonatal Care. 2017; 17: 250-257 Crossref PubMed Scopus (11) Google Scholar This controversy may help to disentangle discrepancies across studies on this topic. Weight z-scores for DM infants in our study indicated a mean decline of 0.74 from birth to day 28 of life, a smaller magnitude of change than 1.00, as reported in preterm formula−fed infants (P < 0.001). In line with most previous reports, 1 Madore L.S. Bora S. Erdei C. et al. Effects of donor breastmilk feeding on growth and early neurodevelopmental outcomes in preterm infants: an observational study. Clin Ther. 2017; 39: 1210-1220 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar , 3 Colaizy T.T. Carlson S. Saftlas A.F. et al. Growth in VLBW infants fed predominantly fortified maternal and donor human milk diets: a retrospective cohort study. BMC Pediatr. 2012; 12: 124 Crossref PubMed Scopus (93) Google Scholar we compared a small amount of DM with formula, meanwhile, Madore et al have analyzed the impact of DM feeding on growth when it constitutes >50% of feeding volumes. Their study brings us closer to the last word on early growth among DM-fed preterm infants: it looks adequate on small amounts of fortified DM, but not on large amounts of DM. More importantly, Madore et al reported no difference in head circumference growth during the neonatal intensive care unit stay, whereas we reported a positive association between head growth before discharge and intake of fortified DM; both findings are in line with any other paper on this topic in the current era of routine fortification of human milk. 4 Maas C. Wiechers C. Bernhard W. et al. Early feeding of fortified breast milk and in-hospital-growth in very premature infants: a retrospective cohort analysis. BMC Pediatr. 2013; 13: 178 Crossref PubMed Scopus (43) Google Scholar Inconsistencies in Outcomes of Donor Breast Milk for Preterm InfantsClinical TherapeuticsVol. 39Issue 12PreviewI would like to thank the Drs. Verd and Ginovart for their very thoughtful commentary in response to our recent article entitled “Effects of Donor Breastmilk Feeding on Growth and Neurodevelopmental Outcomes in Preterm Infants.”1 Their comments, as well as their own recently published paper,2 highlight the ongoing controversy regarding the optimal use of human donor breast milk (DBM) in neonatal intensive care units worldwide. Full-Text PDF