Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Donor human milk largely replaces formula-feeding of preterm infants in two urban hospitals

Journal of Perinatology volume 33, pages 446–451 (2013)Cite this article

Subjects

Abstract

Objective:

To determine acceptance of donor human milk (DM) for feeding preterm infants and whether offering DM, alters mothers’ milk (MM) feeding.

Study Design:

Infant feeding data were collected from medical records of 650 very preterm infants enrolled between 2006–2011 in two hospital level III neonatal intensive care units (NICUs) in Cincinnati, Ohio. The study was conducted during the implementation of a program offering 14 days of DM.

Result:

From 2006–2011, any DM use increased from 8 to 77% of infants, largely replacing formula for the first 2 weeks of life; provision of MM did not change. DM was more likely to be given in the first 2 weeks of life, if infants never received MM or were >1000 g birth weight, but DM use did not differ by sociodemographic factors.

Conclusion:

Offering DM dramatically increased human milk feeding and decreased formula use, but did not alter MM feeding in hospital.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. AAP. Breastfeeding and the use of human milk. American Academy of Pediatrics. Work group on breastfeeding. Pediatrics 1997; 100: 1035–1039.

    Article  Google Scholar 

  2. Quigley MA, Henderson G, Anthony MY, McGuire W . Formula milk versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev. 2007; 17: CD002971.

    Google Scholar 

  3. Schanler RJ . Mother’s own milk, donor human milk, and preterm formulas in the feeding of extremely premature infants. J Pediatr Gastroenterol Nutr 2007; 45: S175–S177.

    Article  Google Scholar 

  4. Schanler RJ, Shulman RJ, Lau C . Feeding strategies for premature infants: beneficial outcomes of feeding fortified human milk versus preterm formula. Pediatrics 1999; 103: 1150–1157.

    Article  CAS  Google Scholar 

  5. Sullivan S, Schanler RJ, Kim JH, Patel AL, Trawöger R, Kiechl-Kohlendorfer U et al. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr 2010; 156: 562–567 e561.

    Article  CAS  Google Scholar 

  6. Porcelli PJ, Weaver RG . The influence of early postnatal nutrition on retinopathy of prematurity in extremely low birth weight infants. Early Hum Dev 2010; 86: 391–396.

    Article  Google Scholar 

  7. Cregan MD, De Mello TR, Kershaw D, McDougall K, Hartmann PE . Initiation of lactation in women after preterm delivery. Acta Obstet Gynecol Scand 2002; 81: 870–877.

    Article  Google Scholar 

  8. Orun E, Yalcin SS, Madendag Y, Ustunyurt-Eras Z, Kutluk S, Yurdakok K . Factors associated with breastfeeding initiation time in a baby-friendly hospital. Turk J Pediatr. 2010; 52: 10–16.

    PubMed  Google Scholar 

  9. Schanler RJ, Lau C, Hurst NM, Smith EO . Randomized trial of donor human milk versus preterm formula as substitutes for mothers’ own milk in the feeding of extremely premature infants. Pediatrics 2005; 116: 400–406.

    Article  Google Scholar 

  10. Bertino E, Giuliani F, Occhi L, Coscia A, Tonetto P, Marchino F et al. Benefits of donor human milk for preterm infants: current evidence. Early Hum Dev 2009; 85: S9–S10.

    Article  Google Scholar 

  11. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Support Breastfeeding. No. Office of the Surgeon General, 2011. http://www.surgeongeneral.gov/topics/breastfeeding/calltoactiontosupportbreastfeeding.pdf (Accessed November 7, 2011).

  12. Ward L, Auer C, Smith C, Schoettker PJ, Pruett R, Shah NY et al. The human milk project: a quality improvement initiative to increase human milk consumption in very low birth weight infants. Breastfeeding Medicine 2012; 7: 234–240.

    Article  Google Scholar 

  13. Lu MC, Lange L, Slusser W, Hamilton J, Halfon N . Provider encouragement of breast-feeding: evidence from a national survey. Obstet Gynecol 2001; 97: 290–295.

    CAS  PubMed  Google Scholar 

  14. Wight NE . Donor human milk for preterm infants. J of perinatol 2001; 21: 249–254.

    Article  CAS  Google Scholar 

  15. Ganapathy V, Hay JW, Kim JH . Costs of necrotizing enterocolitis and cost-effectiveness of exclusively human milk-based products in feeding extremely premature infants. Breastfeeding medicine 2012; 7: 29–37.

    Article  Google Scholar 

  16. Nommsen-Rivers LA, Chantry CJ, Cohen RJ, Dewey KG . Comfort with the idea of formula feeding helps explain ethnic disparity in breastfeeding intentions among expectant first-time mothers. Breastfeed Med. 2010; 5: 25–33.

    Article  Google Scholar 

  17. Guerrero ML, Morrow RC, Calva JJ, Ortega-Gallegos H, Weller SC, Ruiz-Palacios GM et al. Rapid ethnographic assessment of breastfeeding practices in periurban Mexico City. Bull World Health Organ. 1999; 77: 323–330.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Lee HC, Gould JB . Factors influencing breast milk versus formula feeding at discharge for very low birth weight infants in California. J Pediatr. 2009; 155: 657–662 e651-652.

    Article  Google Scholar 

  19. Pineda RG . Predictors of breastfeeding and breastmilk feeding among very low birth weight infants. Breastfeeding medicine 2011; 6: 15–19.

    Article  Google Scholar 

  20. Ostlund A, Nordstrom M, Dykes F, Flacking R . Breastfeeding in preterm and term twins--maternal factors associated with early cessation: a population-based study. J of hum lactat 2010; 26: 235–241 quiz 327-239.

    Article  Google Scholar 

  21. McInnes RJ, Shepherd AJ, Cheyne H, Niven C . Infant feeding in the neonatal unit. Matern Child Nutr. 2010; 6: 306–317.

    Article  Google Scholar 

  22. Mathur NB, Dhingra D . Perceived breast milk insufficiency in mothers of neonates hospitalized in neonatal intensive care unit. Indian J Pediatr. 2009; 76: 1003–1006.

    Article  CAS  Google Scholar 

  23. Meier PP, Engstrom JL, Patel AL, Jegier BJ, Bruns NE . Improving the use of human milk during and after the NICU stay. Clin Perinatol. 2010; 37: 217–245.

    Article  Google Scholar 

  24. Valentine CJ, Morrow G, Morrow AL . Promoting Pasteurized Donor Human Milk Use in the Neonatal Intensive Care Unit (NICU) as an Adjunct to Care and to Prevent Necrotizing Enterocolitis and shorten length of Stay In: Division of Dockets Management (HFA-305) FDA. (eds). FDA: Rockville, MD 20852, 2010 p. 389. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM251799.pdf.

    Google Scholar 

  25. Vohr BR, Poindexter BB, Dusick AM, McKinley LT, Wright LL, Langer JC et al. Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118: e115–e123.

    Article  Google Scholar 

  26. Montjaux-Regis N, Cristini C, Arnaud C, Glorieux I, Vanpee M, Casper C . Improved growth of preterm infants receiving mother's own raw milk compared with pasteurized donor milk. Acta Paediatr. 2011; 100: 1548–1554.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was partially supported by NIH grant funding, as follows: P01 HD13021 (ALM), R01 HD059140 (ALM and KRS), the Medical Student Summer Research Program under T35 DK060444 (ND) and NIH/NCRR 5UL1RR026314. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. We appreciate the expert review of the manuscript by Dr Laurie Nommsen-Rivers and gratefully acknowledge the work of Estelle Fischer, Cathy Grisby, Barbara Alexander, Lenora Jackson, Kristin Kirker, Greg Muthig and Donna Wuest.

Author information

Authors and Affiliations

  1. University of Cincinnati College of Medicine, Cincinnati, OH, USA

    N M Delfosse, L Ward, J Meinzen-Derr, C Valentine, K R Schibler & A L Morrow

  2. Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    L Ward, A J Lagomarcino, C Valentine, K R Schibler & A L Morrow

  3. UC Health Hospital, Cincinnati, OH, USA

    L Ward, C Auer, C Smith & C Valentine

  4. Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    J Meinzen-Derr & A L Morrow

  5. Good Samaritan Hospital, Cincinnati, OH, USA

    K R Schibler

Authors
  1. N M Delfosse
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L Ward
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A J Lagomarcino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Auer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J Meinzen-Derr
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. C Valentine
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K R Schibler
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. A L Morrow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A L Morrow.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Delfosse, N., Ward, L., Lagomarcino, A. et al. Donor human milk largely replaces formula-feeding of preterm infants in two urban hospitals. J Perinatol 33, 446–451 (2013). https://doi.org/10.1038/jp.2012.153

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2012.153

Keywords

This article is cited by

Search

Advanced search

Quick links