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Experience using donor human milk: A single-center cohort study in Japan
Kosuke Oikawa1,2, Yuya Nakano1, Tokuo Miyazawa1
1Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan.
Insights
Donor human milk (DHM) facilitates earlier enteral nutrition (EN) in extremely low birth weight (ELBW) infants. This supports improved early postnatal growth in Japan.
Area of Science:
- Neonatology
- Pediatric Nutrition
- Human Milk Banking
Background:
- Donor human milk (DHM) availability in Japan began in 2017 with the establishment of the first human milk bank.
- Enteral nutrition (EN) is crucial for the growth and development of very low birth weight (VLBW) infants.
Purpose of the Study:
- To investigate the effects of DHM on EN initiation and achievement in VLBW infants in Japan.
- To compare growth outcomes in infants receiving DHM versus those not receiving DHM.
Main Methods:
- Retrospective study of 76 VLBW infants (April 2017-March 2020) at Showa University Hospital.
- Evaluation of age at EN initiation and time to complete feeding (>100 mL/kg/day).
- Comparison between DHM and non-DHM groups, and early human milk (EHM) and non-EHM groups.
Main Results:
- In extremely low birth weight (ELBW) infants, DHM group showed significantly earlier EN initiation.
- Complete feeding was achieved earlier in the EHM group, even after adjusting for complications and gestational age.
- EHM group exhibited significantly greater body weight z-score changes from birth to term-equivalent age.
Conclusions:
- DHM use may promote earlier EN initiation and achievement in ELBW infants.
- Early use of human milk (mother's own or donor) is associated with improved early postnatal growth.
- Findings suggest DHM can be a valuable resource for optimizing nutrition in vulnerable infants in Japan.
Background:
Donor human milk (DHM) became available in Japan when the first human milk bank was established in 2017. This study investigated the effects of DHM on enteral nutrition (EN) in very low birth weight (VLBW) infants in the single center in Japan.
Methods:
Seventy-six VLBW infants hospitalized between April 2017 and March 2020 at Showa University Hospital were included in the study. We retrospectively evaluated age (hours) at which EN was initiated and age (days) until complete feeding (EN > 100 mL/kg/day) was achieved. We compared the DHM and non-DHM groups, or the early human milk (EHM) and non-EHM groups. The EHM group was defined as those in which EN was initiated with the mother's own milk or DHM within 12 h of birth.
Results:
In 30 extremely low birth weight (ELBW) infants, EN was initiated at significantly earlier postnatal hours in the DHM group compared to those in the non-DHM group. Complete feeding was achieved at significantly earlier ages in the EHM group after adjusting for gastrointestinal complications and gestational age. Additionally, the changes in body weight z-scores from birth to term-equivalent age were significantly greater in the EHM group after adjusting for exclusive breastfeeding and small for gestational age, compared to the non-EHM group. Statistical significance was not noted in 46 subjects (birth weight, 1000-1500 g).
Conclusion:
The use of DHM may contribute to earlier initiation and achievement of EN, resulting in greater early postnatal growth in ELBW infants in Japan.
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