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Meta-Analysis
. 2020 Oct 28;15(1):89.
doi: 10.1186/s13006-020-00332-6.

The effect of donor human milk on the length of hospital stay in very low birthweight infants: a systematic review and meta-analysis

Rui Yang  1   2 , Danqi Chen  1   2 , Qingqi Deng  1   2 , Xinfen Xu  3   4
Affiliations
Meta-Analysis

The effect of donor human milk on the length of hospital stay in very low birthweight infants: a systematic review and meta-analysis

Rui Yang et al. Int Breastfeed J. .

Abstract

Background: Donor human milk (DHM) is an alternative to preterm infant formula if the mother's own milk is not available. Since the lactation period and preservation treatment of DHM are different from those of mother's own milk, we aimed to determine the reduction in the length of hospital stay by DHM compared to preterm infant formula.

Methods: In this systematic review, we searched PubMed/MEDLINE, EMBASE, and the Cochrane Library to retrieve studies on the impact of DHM on the clinical outcomes of preterm infants published before 1 November 2019. The study included very low birthweight (VLBW) infants taking either DHM or infant formula with data on the length of hospital stay. Data were analysed using Review Manager 5.3 software.

Results: The literature search yielded 136 articles, and four randomised controlled trials (RCTs) and eight observational studies met the inclusion criteria. A meta-analysis of the RCTs (N = 725) showed no reduction in the length of hospital stay in both the DHM and infant formula groups (- 0.22 days; 95% CI -6.38, 5.95 days), whereas that of the eight observational studies (N = 2496) showed a significant reduction in the length of hospital stay in the DHM group (- 11.72 days; 95% CI -22.07, - 1.37 days). A subgroup analysis of the RCTs revealed that the incidence of necrotising enterocolitis (NEC) was significantly lower in the DHM group when the analysis included high-quality RCTs (RR = 0.32; 95% CI 0.15, 0.69).

Conclusions: This systematic review of RCTs showed that DHM neither prolonged nor shortened the length of hospital stay in VLBW infants compared to preterm infant formula; however, it reduced the incidence of NEC, further validating the protective role of DHM in the health and safety of VLBW infants.

Keywords: Donor human milk; Length of hospital stay; Preterm infant.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Flow chart of the literature search strategy. *Forty-four studies were excluded as they did not meet the inclusion criteria (study population; studies grouping). **A study was excluded when the continuous variables were presented as median and range, and we did not receive usable data from the author
Fig. 2
Fig. 2
The effects of DHM on the length of hospital stay compared to PF. A. RCTS; B. observational studies. Squares (■) represent the effect size of each study. Diamonds (◆) represent the pooled effect size. DHM, donor human milk; PF, preterm infant formula
Fig. 3
Fig. 3
The effects of DHM on NEC compared to PF. A. RCTS; B. observational studies; C. high-quality RCTs studies. Squares (■) represent the effect size of each study. Diamonds (◆) represent the pooled effect size. DHM, donor human milk; PF, preterm infant formula
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