Original ArticleAn Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products
Section snippets
Methods
Infants were recruited from 12 neonatal intensive care units, 11 in the United States and 1 in Austria. Eligibility criteria were as follow: birth weight 500 to 1250 g, intention to receive mother's milk, and ability to adhere to a feeding protocol on the basis of the use of mother's own milk, initiation of enteral feeding before 21 days after birth, and initiation of PN within 48 hours of birth. Infants were excluded if there were major congenital malformations or a high likelihood of transfer
Results
During the 14 months of the study, 334 infants were screened, and 207 were enrolled (Figure 1). The baseline characteristics of infants among the 3 study groups were similar (Table II). The ages of attainment of first enteral feeding (15, 11, and 16 days) and full (140 mL/kg/d) enteral feeding (21, 23, and 22 days) were similar among HM100, HM40, and BOV groups, respectively. There were no significant differences among study groups for the duration of PN, length of hospital stay, late-onset
Discussion
We conducted a randomized controlled multicenter trial to evaluate the potential health benefits of an exclusively human milk diet in extremely premature infants, 500 to 1250 g birth weight. This study was unique for its use of human milk–based human milk fortification. We were unable to demonstrate significant differences among the groups for the primary health outcome, PN days, a surrogate measure for feeding tolerance and early morbidity. Furthermore, we did not find significant differences
References (22)
- et al.
Macronutrient analysis of a nationwide sample of donor breast milk
J Am Diet Assoc
(2009) - et al.
A United States national reference for fetal growth
Obstet Gynecol
(1996) - et al.
Necrotizing enterocolitis: treatment based on staging criteria
Pediatr Clin North Am
(1986) - et al.
Necrotizing enterocolitis in very low birth weight infants: Biodemographic and clinical correlates
J Pediatr
(1991) - et al.
Breast milk and neonatal necrotizing enterocolitis
Lancet
(1990) - et al.
Randomized outcome trial of human milk fortification and developmental outcome in preterm infants
Am J Clin Nutr
(1996) - et al.
Randomised controlled trial of effect of raw and holder pasteurised human milk and of formula supplements on incidence of neonatal infection
Lancet
(1984) Section on Breastfeeding. Breastfeeding and the use of human milk
Pediatrics
(2005)- et al.
Feeding strategies for premature infants: Beneficial outcomes of feeding fortified human milk vs preterm formula
Pediatrics
(1999) - et al.
Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants
Pediatrics
(2005)
The cost-effectiveness of using banked donor milk in the neonatal intensive care unit: Prevention of necrotizing enterocolitis
J Hum Lact
Cited by (748)
Mother's Own Milk Versus Donor Human Milk: What's the Difference?
2024, Critical Care Nursing Clinics of North America
S.S., R.J.S., J.H.K., A.L.P., R.T., U.K.-K., G.M.C., C.L.B., S.A., C.M.C., N.L., R.A.E., G.D., and E.A.C. received financial support from Prolacta Bioscience. The authors were responsible for the conduct of the study and collection of the data. M.L.L. and D.J.R. are employees of Prolacta Bioscience. A.L. is a paid Consultant of Prolacta Bioscience. P.M. received no support or payment. S.A., C.L.B., E.A.C., R.A.E., M.L.L., A.L., P.M., D.J.R., and R.J.S. were responsible for the design of the study. M.L.L. was responsible for the data analyses. R.J.S. wrote the draft of this manuscript. All of the authors were responsible for review and interpretation of the data and review of the manuscript.
Clinicaltrials.gov reg. # NCT00506584