Fortified mother’s own milk (MOM) is the optimal source of nutrition for very low birth weight (VLBW) infants in the neonatal intensive care unit (NICU). Pasteurized donor human milk (PDHM) is recommended for these infants when mother’s own milk is not available, is insufficient or is contraindicated.
Human milk provides short and long-term health benefits for VLBW infants. It improves feed tolerance, thereby reducing the duration of parenteral nutrition and the risk of associated complications. Human milk has been shown to decrease the risk of significant complications of prematurity such as necrotizing enterocolitis (NEC), late-onset sepsis, chronic lung disease, retinopathy of prematurity, and improved neurodevelopment.
Any evaluation of the clinical impact of the introduction of donor milk into the NICU must evaluate whether the use of donor human milk affected the feed tolerance, duration of parenteral nutrition use, growth, rates of NEC, late-onset sepsis, length of hospital stay (LOS), and mortality. The impact of availability of PDHM on MOM and breastfeeding rates at discharge should be evaluated as well. Several studies have shown increased rates of feeding with MOM post establishment of a donor human milk due to heightened awareness about the benefits of human milk amongst mothers of VLBW infants.
Long term follow-up of such infants for neurodevelopment as well recurrent hospital admissions for respiratory or gastrointestinal infections should be included in such study models.
Lastly, evaluating the cost effectiveness of supplying PDHM to VLBW infants in the NICU will serve to justify the higher cost of PDHM as compared to preterm formula milk.
