Introducing Donor Milk in a Neonatal Intensive Care Unit: A Developing Country's Perspective

To replace 75 % of formula feeds by donor human milk (DHM) feeds in the first three days of life in neonates admitted to the neonatal intensive care unit (NICU).

It was a prospective observational study in the NICU in a resource-limited set up in India. All neonates admitted during December 2013 and August 2014, were included in the study without any exclusion. Expressed DHM was administered within 2-3 h of manual expression without refrigeration or pasteurization. It was left standing at room temperature in a covered stainless steel container prior to use. Prospective entries of 2 hourly neonatal feeds, for first 3 d of life, (36 entries) were made in the charts. Main outcome was the desired percentage replacement of formula feeds.

Total 168 neonates were admitted to the NICU over the study period. Their median [Interquartile range (IQR); Range] gestation and birth weight was 37 (36, 38; 24-42) wk and 2300 (2100, 2700; 500-2950) g respectively. A total of 4136/6027 (68.6 %) charted feeds were of human milk and 1891(31.4 %) were of formula milk. Thus, 68.6 % of formula feeds were replaced by DHM. Neonates weighing ≤2 kg were at a lower risk of getting >25 % formula feeds.

A simple low cost method was effective in replacing a significant proportion of formula feeds by DHM in the first three days of life for neonates in a resource poor set up.