Supplemental Donor Milk vs Infant Formula in Moderate to Late Preterm Infants: A Randomized Clinical Trial

Area of Science:

• Neonatal nutrition
• Pediatric gastroenterology
• Clinical trials

Background:

• High-quality evidence supports pasteurized donor human milk (donor milk) for very preterm infants with insufficient maternal milk.
• Evidence is lacking for its use in more mature preterm infants.

Purpose of the Study:

• To compare the effect of donor milk versus term infant formula on establishing full enteral feeds in moderate to late preterm infants with insufficient maternal milk.
• To evaluate secondary outcomes including feed intolerance, growth, and hospital readmissions.

Main Methods:

• Multisite, blinded randomized clinical trial involving infants born between 32 and 36 weeks' gestation.
• Infants received supplemental donor milk or term formula for up to 8 days.
• Primary outcome was time to full enteral feeds (150 mL/kg/day); follow-up to 6-month corrected age.

Main Results:

• Mean time to full enteral feeds did not differ significantly between the donor milk and formula groups (5.7 vs 5.8 days).
• Secondary outcomes were similar, except for a slower rate of birth weight regain in the donor milk group.
• No significant difference in feed intolerance, growth, or hospital readmissions was observed.

Conclusions:

• Supplemental donor milk did not reduce the time to establish full enteral feeds in moderate to late preterm infants compared to term formula.
• Donor milk did not show a significant advantage over formula for the studied outcomes in this population.
• Further research may be needed to explore specific benefits or risks of donor milk in this age group.