A study published in the Journal of the American Medical Association explores the impact of feeding extremely preterm infants with nutrient-fortified, pasteurized donor human milk versus preterm formula. 483 infants were randomized, with 239 in the donor milk group and 244 in the preterm formula group. The median gestational age of the infants was 26 weeks, and the median birth weight was 840 grams.
The study showed that weight gain was slower in the donor milk group (22.3 g/kg/day) compared to the preterm formula group (24.6 g/kg/day). By the end of the study, the mean weight in the donor milk group was 143 grams lower than that in the preterm formula group. Despite the difference in weight gain, both groups had similar initial weight, length, and head circumference, and there were no significant differences in length and head circumference growth during the study.
Neurodevelopmental outcomes assessed at 22 to 26 months’ corrected age showed no significant differences between the two groups. The adjusted mean cognitive score was 80.7 in the donor milk group versus 81.1 in the preterm formula group, indicating an insignificant between-group mean difference. Motor and language scores also did not differ significantly between the groups. The prevalence and severity of neurodevelopmental impairment and cerebral palsy were similar in both groups.
Mortality rates prior to hospital discharge and follow-up were slightly higher in the donor milk group (10% and 13%, respectively) compared to the preterm formula group (7.4% and 11%, respectively). However, the incidence of necrotizing enterocolitis was significantly lower in the donor milk group (4.2%) than in the preterm formula group (9.0%).
The study's findings suggest that donor milk does not disadvantage developmental outcomes compared to preterm formula. As one of the study’s investigators, Tarah Colaizy, professor of pediatrics–neonatology in the Stead Family Department of Pediatrics at the UI Carver College of Medicine, mentioned to Iowa Now, “What we showed in this study is that there was no disadvantage developmentally with the use of donor milk, which in itself is an important finding. We also verified that if you don’t have mother’s milk as a choice, the use of donor milk compared to preterm formula is associated with a decreased incidence of necrotizing enterocolitis.”
This study highlights the importance of donor milk as a viable alternative to preterm formula when maternal milk is not available, without compromising developmental outcomes and potentially offering protective benefits as well.
Sources: Journal of the American Medical Association, Iowa Now
