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

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.

Figure 1

UH. (a) Annual milk volumes as a percent of total milk feedings of preterm infants for DOL 1–14. (b) Annual frequency of different milk feeding patterns over DOL 1–14. DM, Donor; F, Formula; human milk; MM, mother’s own milk. MM & F group includes infants regardless of whether they received donor milk. Data from UH only, n = 474 infants.

Figure 2

Average daily percent of enteral feeds composed of MM, DM and formula for DOL 1–3, 4–14 and 22–28. Each horizontal bar represents an individual infant’s feeding pattern over time. Infants are grouped based on their feeding pattern during DOL 1–3: Exclusive MM, Mixed MM (MM & any other feeding type), DM (no MM), exclusive formula and no enteral feeds. Data from 2009–2011, both hospitals, n = 237 infants.

Figure 3

Percent of total intake of MM, DM and F for each infant DOL, by insurance type (a) Medicaid insurance; (b) Private insurance). Data from 2009–2011, both hospitals, n = 237 infants.