Donor human milk for preterm infants: current evidence and research directions

Creators: Arslanoglu, Sertac and Corpeleijn, Willemijn and Moro, Guido and Braegger, Christian and Campoy, Cristina and Colomb, Virginie and Decsi, Tamas and Domellöf, Magnus and Fewtrell, Mary and Hojsak, Iva and Mihatsch, Walter and Molgaard, Christian and Shamir, Raanan and Turck, Dominique and Van Goudoever, Johannes B. and ESPGHAN Committee on Nutrition
Title: Donor human milk for preterm infants: current evidence and research directions
Item Type: Article or issue of a publication series
Journal or Series Title: Journal of Pediatric Gastroenterology and Nutrition : JPGN
Page Range: pp. 535-542
Date: 2013
Divisions: Gesundheitsmanagement
Abstract: The Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition aims to document the existing evidence of the benefits and common concerns deriving from the use of donor human milk (DHM) in preterm infants. The comment also outlines gaps in knowledge and gives recommendations for practice and suggestions for future research directions. Protection against necrotizing enterocolitis is the major clinical benefit deriving from the use of DHM when compared with formula. Limited data also suggest unfortified DHM to be associated with improved feeding tolerance and with reduced cardiovascular risk factors during adolescence. Presence of a human milk bank (HMB) does not decrease breast-feeding rates at discharge, but decreases the use of formula during the first weeks of life. This commentary emphasizes that fresh own mother's milk (OMM) is the first choice in preterm infant feeding and strong efforts should be made to promote lactation. When OMM is not available, DHM is the recommended alternative. When neither OMM nor DHM is available, preterm formula should be used. DHM should be provided from an established HMB, which follows specific safety guidelines. Storage and processing of human milk reduces some biological components, which may diminish its health benefits. From a nutritional point of view, DHM, like HM, does not meet the requirements of preterm infants, necessitating a specific fortification regimen to optimize growth. Future research should focus on the improvement of milk processing in HMB, particularly of heat treatment; on the optimization of HM fortification; and on further evaluation of the potential clinical benefits of processed and fortified DHM.
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Citation:

Arslanoglu, Sertac and Corpeleijn, Willemijn and Moro, Guido and Braegger, Christian and Campoy, Cristina and Colomb, Virginie and Decsi, Tamas and Domellöf, Magnus and Fewtrell, Mary and Hojsak, Iva and Mihatsch, Walter and Molgaard, Christian and Shamir, Raanan and Turck, Dominique and Van Goudoever, Johannes B. and ESPGHAN Committee on Nutrition (2013) Donor human milk for preterm infants: current evidence and research directions. Journal of Pediatric Gastroenterology and Nutrition : JPGN, 57 (4). pp. 535-542. ISSN 0277-2116

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