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Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Eduardo Villamor-Martínez1, Maria Pierro2, Giacomo Cavallaro3

  • 1Department of Pediatrics, Maastricht University Medical Center (MUMC+), School for Oncology and Developmental Biology (GROW), 6202 AZ Maastricht, The Netherlands. evillamorm@gmail.com.

Nutrients
|February 21, 2018
PubMed

Insights

Pasteurized donor human milk (DHM) may protect very preterm infants from bronchopulmonary dysplasia (BPD). While not confirmed in RCTs, observational studies suggest DHM reduces BPD risk, supporting its use when mother's own milk is unavailable.

Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Respiratory Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a primary complication in preterm infants.
  • Pasteurized donor human milk (DHM) is increasingly used for very preterm infants when mother's own milk (MOM) is unavailable.
  • Previous studies suggest potential benefits of DHM for BPD.

Purpose of the Study:

  • To systematically review and meta-analyze evidence on the effects of DHM on BPD and other respiratory outcomes in very preterm infants.
  • To compare DHM with preterm formula (PF) and evaluate exclusive human milk diets.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies.
  • Inclusion of eighteen studies meeting predefined criteria.
  • Analysis of outcomes including BPD incidence.

Main Results:

  • Meta-analysis of RCTs did not show a significant reduction in BPD with DHM supplementation compared to PF (RR 0.89, 95% CI 0.60-1.32).
  • Meta-analysis of observational studies indicated that DHM supplementation reduced BPD risk (RR 0.78, 95% CI 0.67-0.90).
  • Exclusive human milk diets and raw MOM feeding showed protective effects against BPD.

Conclusions:

  • Data suggest that pasteurized donor human milk (DHM) may offer protection against bronchopulmonary dysplasia (BPD) in very preterm infants.
  • Observational data support DHM's role in reducing BPD, warranting further investigation in RCTs.
  • Human milk-based diets are associated with reduced BPD risk.

Keywords:
breast milkbronchopulmonary dysplasiadonor human milkpasteurizationpreterm formula

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