Effects of Donor Breastmilk Feeding on Growth and Early Neurodevelopmental Outcomes in Preterm Infants: An Observational Study.
Study Goal
The researchers aimed to evaluate the effects of a predominantly donor breastmilk (DBM) diet on growth and neurodevelopment in preterm infants compared to mother's own milk (MOM) or preterm formula (PF).
Results Summary
Preterm infants fed predominantly DBM regained birthweight more slowly initially and scored lower in cognitive assessments at 1 and 2 years compared to those fed MOM or PF, though growth differences diminished over time.
Population
Preterm infants in a level 3 neonatal intensive care unit (NICU) with a mean gestational age of 27.1 weeks and mean birthweight of 914 g.
Effective Dosage
Predominantly (>50%) DBM, MOM, or PF supplementation.
Duration
First month of life for growth assessment; neurodevelopment assessed at 1 and 2 years' corrected age.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
predominantly (>50%) donor breastmilk (DBM) diet | decrease | birthweight regain over the first month of life | preterm infants | mean (SD) 17.9 (5.7) g/kg/d vs 22.0 (6.8) for MOM and 20.3 (5.7) for PF | regained birthweight more slowly | #1 |
predominantly (>50%) donor breastmilk (DBM) diet | decrease | cognition at 1 year of age | preterm infants | P = 0.005 | scored significantly lower in cognition | #2 |
predominantly (>50%) donor breastmilk (DBM) diet | decrease | cognition at 2 years of age | preterm infants | P = 0.03 | scored significantly lower in cognition | #3 |
predominantly (>50%) donor breastmilk (DBM) diet | decrease | early in-hospital weight gain | preterm infants | - | had compromised early in-hospital weight gain | #4 |
predominantly (>50%) donor breastmilk (DBM) diet | decrease | early cognitive development | preterm infants | - | had possibly early cognitive delays | #5 |
PURPOSE: Donor breastmilk (DBM) has gained popularity as an alternative to formula when mother's own milk (MOM) is unavailable. The objective of this study was to evaluate the effects of a predominantly DBM diet on growth and subsequent neurodevelopment in preterm infants at a level 3 neonatal intensive care unit (NICU). METHODS: This single-center, observational cohort study compared data from preterm infants supplemented with predominantly (>50%) DBM to those from age- and weight-matched infants fed only MOM or supplemented with predominantly (>50%) preterm formula (PF). The primary outcome was in-hospital weight gain, and the secondary outcome was neurodevelopment, as assessed by the Bayley III scale at 1 and 2 years' corrected age. Exclusion criteria were major congenital defects, death prior to discharge from the NICU, or supplementation volumes of <50% over the first month of life. We compared the outcomes among the 3 feeding groups with the χ FINDINGS: In the entire cohort, the mean gestational age was 27.1 weeks and the mean birthweight was 914 g. The DBM (n = 27) and PF (n = 25) groups were similar with regard to socioeconomic characteristics. DBM infants regained birthweight more slowly over the first month of life compared with infants fed MOM (n = 29) or PF (mean [SD], 17.9 [5.7], 22.0 [6.8], and 20.3 [5.7] g/kg/d, respectively; P = 0.05); however, this growth difference was attenuated at later time points. In a fully adjusted model, the DBM group scored significantly lower in cognition at both 1 year (P = 0.005) and 2 years (P = 0.03) of age compared with the infants fed non-DBM diets. IMPLICATIONS: The findings from this study suggest that in this NICU, preterm infants supplemented with predominantly DBM had compromised early in-hospital weight gain and, possibly, early cognitive delays compared with infants fed only MOM or infants supplemented with predominantly PF. These findings reinforce the need for further research on the optimal use of DBM in the preterm population and a continued need for promoting breastfeeding efforts to supply MOM.