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Review
. 2025 Jan 1;28(1):33-38.
doi: 10.1097/MCO.0000000000001084. Epub 2024 Nov 11.

Formula protein versus human milk protein and the effects on growth in preterm born infants

Jacqueline Muts  1   2 , Britt J van Keulen  1   2 , Johannes B van Goudoever  1   2 , Chris H P van den Akker  2   3
Affiliations
Review

Formula protein versus human milk protein and the effects on growth in preterm born infants

Jacqueline Muts et al. Curr Opin Clin Nutr Metab Care. .

Abstract

Purpose of review: This review aims to evaluate the latest available evidence on the differences between human milk proteins versus infant formula proteins and its effects on growth and development in preterm infants.

Recent findings: High protein intake supports initial growth in preterm infants, although the long-term benefits remain unclear. Human milk requires adequate fortification to meet nutritional needs of preterm born infants. Formula feeding, with its higher protein content, may accelerate early weight gain but also increases the risk of necrotizing enterocolitis. Current evidence showed no significant advantages of human milk-derived fortifiers over bovine milk-derived fortifiers. Furthermore, studies published during the review period do not provide new evidence that alters the existing understanding of differences in neurodevelopmental outcomes between infants fed human milk and those fed formula.

Summary: Both fortified human milk and preterm formula support growth in preterm infants, but human milk offers additional protective benefits, such as reducing the risk of necrotizing enterocolitis, making it the preferred option. Balancing immediate growth needs with potential long-term developmental outcomes remains crucial, highlighting the need for further research to determine the optimal protein intake for preterm infants.

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Conflict of interest statement

J.M.: Nothing to disclose.

B.J.v.K.: Nothing to disclose.

J.B.v.G.: J.B.v.G. is the founder and director of the Dutch National Human Milk Bank and a member of the National Health Council. J.B.v.G. has been a member of the National Breastfeeding Council from March 2010 to March 2020. He received a grant to determine P.F.A.S. concentrations in human milk from The National Institute for Public Health and The Environment (RIVM) in 2024.

C.H.P.v.d.A.: C.H.P.v.d.A. reports receipt of speakers and consultancy honoraria from Nestlé Nutrition Institute, Nutricia Early Life Nutrition, and Baxter; used as research funds. He is vice-director of the Dutch National Human Milk Bank and a member National Breastfeeding Council since 2024.

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References

    1. Embleton ND, Jennifer Moltu S, Lapillonne A, et al. . Enteral Nutrition in Preterm Infants (2022): A position paper from the ESPGHAN Committee on Nutrition and Invited Experts. J Pediatr Gastroenterol Nutr 2023; 76:248–268. - PubMed

    2. This position paper provides evidence-based recommendations on enteral nutrition in preterm infants, addressing the optimal composition, timing, and volume to support growth and development.

    1. Joosten K, Vermeulen M. Principles of feeding the preterm infant. Clin Nutr ESPEN 2024; 59:320–327. - PubMed
    1. Quigley M, Embleton ND, Meader N, McGuire W. Donor human milk for preventing necrotising enterocolitis in very preterm or very low-birthweight infants. Cochrane Database Syst Rev 2024; 9:CD002971. - PMC - PubMed

    2. This updated systematic review evaluates the effectiveness of donor human milk in reducing the risk of necrotizing enterocolitis and other complications in very preterm or very low-birthweight infants compared to formula feeding.

    1. Andres SF, Scottoline B, Good M. Shaping infant development from the inside out: bioactive factors in human milk. Semin Perinatol 2023; 47:151690. - PMC - PubMed
    1. Hu Y, Wu X, Zhou L, Liu J. Which is the optimal choice for neonates’ formula or breast milk? Nat Prod Bioprospect 2024; 14:21. - PMC - PubMed

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