This site uses cookies to store information on your computer. Learn more x


Providing perspectives on recent research into vitamins and nutritionals


Using Donor Human Milk in Very Low Birth Weight Infants

By Julia Bird

TalkingNutrition has written before on the topic of donor human milk for healthy, term infants. Now, a study from Kantorowska and co-workers has been published looking at the effect of introducing a donor milk program for very low birth weight (VLBW) infants. VLBW infants are defined as having a birth weight of less than 1500 g and make up 1.4% of births in the US, or around 20 million births worldwide.  The most common cause of low birth weight is preterm birth, and VLBW is generally seen in infants born before 30 weeks of gestation, although intrauterine growth restriction is also a cause.

The diet of a premature infant is different to a term infant, as it has to attempt to provide the nutrients normally transferred across the placenta during pregnancy. VLBW infants are particularly difficult to feed as their gastrointestinal system is immature and they may not be able to tolerate the volumes of milk that would be needed to meet their nutrient needs. Intravenous nutrient solutions are often used initially, with the amount of milk gradually increased over the first weeks.

Over the past 100 years we appear to have come back to where we started with the type of milk used in premature infants. At the turn of the century, as Greer summarizes in a fascinating historical article, breast milk was seen as the best option for feeding these “weaklings”. As preterm births can often be the result of serious health conditions in the mother, as was the case with two friends of mine who developed eclampsia during their pregnancy and were not able to breast feed, wet nurses were able to provide breast milk for premature infants if the mother was not able. By the 1940s, it was known that normal breast milk did not contain enough protein, minerals and vitamins to enable the infant to grow at the same rate as it would have inside the womb. Formulas were developed in the 1980s specially for preterm infants, and weight gain of VLBW infants was found to be a little better than those fed breast milk. Human milk fortifiers that contained the extra nutrients could also be added to breast milk so that it could better meet the needs of preterm infants. In the 1990s, human milk (with or without fortifiers) was again being recommended to help prevent the dreaded, life-threatening disease necrotizing enterocolitis, in which part of the tissue of the small or large intestine becomes damaged and starts to die off, potentially causing intestinal contents to leak into the bowel cavity. Although the risk varies with prematurity, rates are around 5% of VLBW infants (see Ahle, Drott and Andersen).

However, the evidence base for choosing infant formula or breast milk is not unequivocal. A Cochrane review from April 2014 found that the evidence base was limited, but that the rate of necrotizing enterocolitis was 2-3 times higher when infant formula was used compared to donor breast milk. There were no trials of formula compared to maternal breast milk. Some groups have found that the use of breast milk translates to lower newborn intensive care unit costs (Assad), whereas others have found no significant differents (Parker).   

The article by Kantorowska described whether donor human milk availability affected rates of necrotizing enterocololitis in Californian newborn intensive care units. Donor human milk has become more widely available in California over the past ten years, through organizations such as the Human Milk Banking Association of North America. The authors were able to link patient level data collected as the California Perinatal Quality Care Collaborative with the availability of human donor milk at hospitals. They found that 22 hospitals showed a clear transition to using donor milk (presumably the transition resulted in a reduction in the use of infant formula) over the study period.

The authors found that the rate of necrotizing enterocolitis was reduced by 2.5% in the hospitals that could provide donor human milk. Rates of any breastfeeding at discharge were also increased by 10% in these hospitals. This study reinforces that human breast milk is the “optimal way of feeding infants”. Donor human milk can help the most vulnerable VLBW infants.


Main citation:

Agata Kantorowska, Julia C. Wei, Ronald S. Cohen, Ruth A. Lawrence, Jeffrey B. Gould, Henry C. Lee. Impact of Donor Milk Availability on Breast Milk Use and Necrotizing Enterocolitis Rates. Pediatrics March 2016.

Supporting citations:

Assad M, Elliott MJ, Abraham JH. Decreased cost and improved feeding tolerance in VLBW infants fed an exclusive human milk diet. J Perinatol. 2015 Nov 12. doi: 10.1038/jp.2015.168. [Epub ahead of print]

DSM Corporate Public Affairs. DSM Position on Infant Formula. April 2013.

Frank R. Greer. Feeding the Premature Infant in the 20th Century. J. Nutr. 2001 131: 2 426S-430S.

Parker LA, Krueger C, Sullivan S, Kelechi T, Mueller M. Effect of breast milk on hospital costs and length of stay among very low-birth-weight infants in the NICU. Adv Neonatal Care. 2012 Aug;12(4):254-9. doi: 10.1097/ANC.0b013e318260921a.

Quigley M, McGuire W. Formula milk versus donor breast milk for feeding preterm or low birth weight infants. 22 April 2014

You are signed in as:
Hello, Here we are providing you the best portal for play spider solitaire free online games. These games are of cards and can be enjoyed online easily without facing any type of hurdle. These games are scoring games of points.
0 Replies » Reply
20170919 junda target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'>
0 Replies » Reply
jlgg September 19, 2017 10:00 AM Oakley Sunglasses prada outlet online ray-ban sunglasses school bags online sale Nike Air Max prada outlet woodbury fake sunglasses kate spade outlet nike shox payless shoes target='_blank' style='color: #000; text-decoration: underline;'> timberland boots Kaufen Nike Air Max 1 prada handbags black friday deals Nike Air Max 1 kanye west shoes salomon sneakers target='_blank' style='color: #000; text-decoration: underline;'> coach australia kate spade outlet timberland australia yeezy boost 350 white snow boots uk ray ban shop Oakley Sunglasses prada sale Jewelry Armoire - Official Air Max 1 Homme yeezy boost 350 shoes payless shoes pandora deutschland Cartier Watches backlink puma shoes hermes outlet under armour michael kors uk online yeezy boost 350 shoes coach outlet online pandora charms sale clearance michael kors Air Jordan Retro 3 coach outlet online kate spade outlet rayban prescription sunglasses michael kors outlet Jared Jewelry - Official spendless shoes hermes outlet pandora bracelets charms Air Jordan 11 Femme pandora rings sunglasses sm Brighton Jewelry - Official pandora uk Nike Air Max Enfant shop mlb homepage keywords Prada Shoes - Official oakley outlet michael kors online softball jerseys pandora australia official chrome hearts swatch watch Adamson puma sneakers moncler jacket ray ban sunglasses north face sale Chaussures pour Femme outlet sale skechers shoes Air Max 90 Femme Air Max 180 ray ban sale Longchamp outlet rayban sunglasses ray ban justin prada outlet online Abercrombie Fitch ray ban frames michael kors handbags Nike Air Jordan enfants Burberry Australia kate spade outlet kate spade polo outlet myhermes parcel shop coach outlet ray-ban glasses ray-Ban sunglasses school bags online payless shoes puma suede Nike Air Max Femme Nike Air Max puma oulet sale Nike Air Max official michael kors Dreamland Jewelry - Official Coach Handbags kate spade Nike Free target='_blank' style='color: #000; text-decoration: underline;'> louis vuitton purse chrome store michael kors bags sunglasses store pandora jewelry puma sneakers black friday yeezy boost 350 pandora sale birkenstock outlet kate spade australia coach australia mcm australia nbastore gel kayano nflshop com tracking ups Adidas Outlet michele watch birkenstock sandals kate spade italy Prada Shoes - Official discount oakley sunglasses coach outlet us chaussures nike Michael Kors Handbags Outlet Sale pandora jewelry uk official coach outlet site coach outlet online louis vuitton The Retail Compliance Association pandora uk ray ban sunglasses Nike Air Jordan Enfants ray ban uk kate spade outlet online Nike Free 3.0 target='_blank' style='color: #000; text-decoration: underline;'> michael kors outlet hot dor Burberry Shirt - Official ray ban outlet michael kors coach outlet online ?m th?c louis vuitton outlet nike running puma australia Nike Air Max Couple pandora charms pandora uk prada outlet moncler us Nike Free clb shoes sale pandora charms pandoracharms louis vuitton us michael kors watches Wholesale Outlet Sale ray ban wayfarer sunglasses prada outlet online evbid yeezy boots 350 fun games for kids pandora charms uk shoes sale michael kors outlet online kate spade coach factory outlet prada outlet sale yeezy shoes under armour stock seiko watches michael kors outlet online oakley sunglasses kate spade wallet outlet Air Jordan 10 prada online pandora sale NIKE Schuhe Shop pandora charms sale Pharmacy Discount Network michael kors coach tennis shoes coach outlet Wedding Rings- Official ray ban online coach bags Nike Blazer Femmes celine outlet online Sunglasses outlet sale ray ban erika michael kors outlet target='_blank' style='color: #000; text-decoration: underline;'> timberland boots Nike Free Run rayban prescription glasses louis vuitton bags chaussure pas cher michael kors purses Wave Prophecy 2 Shoes kate spade bags trazodone100mg burberry bags outlet michael kors outlet birkenstock sandals coach watches Jordan Fusion Femme michael kors Air Jordan Femme ray-ban eyeglasses Nike Air Jordan Enfants Nike Air Jordan Enfants ugg boots Air Max 90 Nike Air Max 2017 canada goose outlet louis vuitton outlet sunglasses louis vuitton outlet online Nike Air Max 90 Nike Air Force Wave Prophecy 2 Shoes pandora jewelry sale louis vuitton bags kate spade outlet Nike Schuhe Damen coach usa online Salomon Speedcross Shoes handbags online sale 80's Fashion pandora uk boulder shoes sew repair breitling watches Nike Air Max 90 Mes coachs outlet Kruz-graphix pandora charms Brighton Jewelry - Official coach outlet online sunglasses puma shoes nike running shoes target='_blank' style='color: #000; text-decoration: underline;'> coach carter hermes belt michael kors outlet online Markenschuhe Online Oyun ugg outlet payless shoes sale puma sneakers online Jewelry Armoire - Official Nike KD 8 prada us kate spade purses ray ban shop pandora rings uk kate spade bags michael kors outlet online Prada Sunglasses - Official balenciaga outlet ugg boots ralph lauren polo chaussures asics femme the beat omega watches Longchamp tote chrome store canada Watches Air Max Enfants burberry australia ray ban sunglasses sale pandora jewelry diesel watches nike huarache shoes Nike Free Run michael kors outlet Nike Air Jordan Homme Air Jordan Enfant chanel bag Air Jordan Homme Nike Shox R3 ray ban wayfarer ray ban sunglasses outlet louis vuitton outlet Zales Jewelry michael kors Air Max Enfants birkenstock canada mens sunglasses pandora outlet Air Jordan Fly 23 snow boots Diamond Rings - Official Prada Bags pandora charms outlet tiffany co Engagement Rings - Official Air Max 180 michael kors us gucci watches puma outlet oakley sunglasses Nike Air Max 2017 burberry scarf ugg uk Air Max 180 black friday kate spade mk outlet online moncler sale Nike Air Max 2017 birkenstock gizeh michael kors outlet Nike Air Max Chase michael kors ray ban outlet michael kors bags Nike Air Max 1 black friday shopping official kate spade website payless shoes Premier Jewelry. - Official Nike Air Max Enfant michael kors shoes michael kors outlet Nike Dunk SB Low Dreamland Jewelry - Official casio watches Chanel Outlet Coach Sunglasses Outlet michael kors outlet kate spade outlet BURBERRYburberry australia ua shoes burberry australia Jimmy Choo Shoes Hermes Outlet Black Friday Sales chrome store Nike Air Max 90 Nike Air Jordan Enfants mode damenschuhe moncler outlet yeezy shoes top sunglasses louis vuitton outlet online fulam shoes Green Cleaned burberry outlet sale coach factory outlet michael kors outlet michael kors michael kors australia official tiffany co Jordan Flight 45 Femme Add Your Link Free moncler outlet birkenstock outlet ugg boots Nike Air Max 2017 Nike Boots timberland shoes Nike Air Jordan Enfants kate spade outlet bags Rolex Watch Nike Schuhe business blog under armour outlet michael kors outlet michael kors outlet online birkenstock Nike Schuhe Herren birkenstock outlet Air Max 95 Nike Air Max 180 coach outlet store coach outlet Nike Free Run Nike Jordans puma outlet online chrome store coach sale canada goose outlet hermes bag under armour shoes Nike Air Jordan Air Max 180 Homme louboutin shoes China wholesale Nike Air Max Promise Rings - Official hermes bag Nike Air Force 1 Homme louis vuitton outlet Prada Outlet pandora rings michael kors outlet hermes belt pandora rings ray ban clubmaster sunglasses school bags on sale Air Max 90 Femme prada outlet online pandora uk michael kors bags Michael Kors Outlet abercrombie canada michael kors outlet online timberland boots pandora rings Kate Spade - Online Sale rolex watch michael kors outlet online ray ban polarized sunglasses payless near me louisvuitton outlet michael kors outlet bags Lisinopril 10mg Us birkenstock sandals Nike Air Jordan Enfants coach handbags sale ray ban sunglasses burberry outlet canada michael kors outlet online payless shoes online Nike Air Max 2017 burberry outlet coach outlet online sale Prada bags Nike Zoom louis vuitton ugg uk michael kors Doxycycline Kay Jewelers - Official ray ban outlet Nike Air Max 90 pas cher france michael kors Premier Jewelry - Official Ray Ban sunglasses michael kors coach factory outlet puma outlet michael kors outlet nike jordan shoes birkenstock sunglasses timberland outlet sunglasses hut kate spade outlet online Jared Jewelry - Official Obat Kuat Sex articles
" Wholesale womens autumn winter clothing
0 Replies » Reply
0 Replies » Reply
0 Replies » Reply target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'> target='_blank' style='color: #000; text-decoration: underline;'>
0 Replies » Reply
Simon November 8, 2017 1:35 PM
It was a really cool event, it will be remembered for a long time by everyone. Thank you for the article
Read more at :
0 Replies » Reply