Donor Human Milk Compared With Formula Supplementation for Breastfeeding Term Newborns Treated With Phototherapy

To compare the effects of donor human milk and formula supplementation on bilirubin levels and total phototherapy duration among term breastfeeding newborns who received phototherapy for neonatal hyperbilirubinemia.

Retrospective, nonexperimental observational study.

Well-newborn nurseries in four health care facilities in Central and North Texas.

Charts of breastfeeding term newborns (≥37 weeks gestation) who underwent phototherapy and received supplementation for the management of neonatal hyperbilirubinemia (N = 383).

We compared the charts of breastfeeding newborns who received supplemental formula with the charts of those who received supplemental donor human milk. We analyzed group differences in bilirubin levels, phototherapy duration, and supplementation volume using independent-samples t tests, with effect sizes calculated as Cohen's d and reported with 95% confidence intervals (CIs).

We found that newborns who received supplemental donor human milk spent approximately 6 more hours on phototherapy than those who received formula (31.57 vs. 25.99 hours; d = 0.35; 95% CI [0.15, 0.56], p < .001). Final bilirubin levels did not differ significantly between groups (10.16 vs. 10.39 mg/dl; p = .63). Newborns who were given supplemental formula received more than twice the supplementation volume as those who were given supplemental donor human milk (344.63 vs. 982.00 ml; d = 5.82; 95% CI [0.90, 10.71], p = .01).

Breastfeeding newborns with neonatal hyperbilirubinemia who receive supplemental donor human milk as an alternative to formula supplementation may spend more time on phototherapy.