Abstract
BackgroundHuman milk (HM) is the best feeding for premature infants. When own mother’s milk (OMM) is insufficient or unavailable, pasteurized donor human milk (PDHM) and preterm formula (PF) are the alternative nutritional sources, but the benefits of donor milk over formula are not defined. This study aimed to assess whether, in the absence of OMM, the PF could guarantee a feeding tolerance not inferior to that seen with the use of PDHM during the first two weeks of life of very preterm infants.MethodsInfants with gestational age (GA) of ≤32 weeks who started enteral feeding within the first 7 days of life were randomized to receive PDHM or PF as a supplement to the OMM insufficient or unavailable. The primary outcome was the day of life when full enteral feeding (FEF) of 150 mL/Kg/d was achieved.ResultsSeventy infants were randomized, 35 in the PF group (GA 30.2 ± 1.7 weeks; BW 1342 ± 275 g), 35 in the PDHM group (GA 30 ± 1.9 weeks; BW 1365 ± 332 g). The time to achieve FEF was the same for infants fed with PF and for infants fed with PDHM (12.3 ± 7.0 days vs 12.8 ± 6.5).ConclusionsThis trial shows that PF could be a valid alternative for the early feeding of very preterm infants when OMM is insufficient or unavailable.Trial registrationUMIN000013922. Date of formal registration: December 31, 2014.
Highlights
Human milk (HM) is the best feeding for premature infants
pasteurized donor human milk (PDHM) is stated as the most appropriate alternative to promote feeding tolerance [6], it seems that PDHM does not have the same benefits of own mother’s milk (OMM)
We found that, if the OMM is insufficient or unavailable, the preterm formula (PF) can ensure a feeding tolerance not inferior to that seen with the use of PDHM during the first two weeks of life in very preterm infants
Summary
When own mother’s milk (OMM) is insufficient or unavailable, pasteurized donor human milk (PDHM) and preterm formula (PF) are the alternative nutritional sources, but the benefits of donor milk over formula are not defined. When OMM is insufficient or unavailable, pasteurized donor human milk (PDHM) and preterm formula (PF) are the alternative sources of enteral feeding for premature infants. PDHM is stated as the most appropriate alternative to promote feeding tolerance [6], it seems that PDHM does not have the same benefits of OMM This is because the process of pasteurization reduces the content and function of some host defence proteins and cellular elements [3, 7]. Premature infants fed with PDHM appear to have a lower risk of necrotizing
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