Banked preterm versus banked term human milk to promote growth and development in very low birth weight infants

Abstract

There are no randomised trials that compare preterm banked milk to banked term milk to promote growth and development in very low birth weight infants.

Breast milk banking: Current opinion and practice in Australian neonatal intensive care units

“…Another main concern when considering establishing a BMB is the considerable set‐up and maintenance costs. The process of screening donors, pasteurising, storing and shipping of PDBM all carry a significant cost 3 . However, these costs are easily offset by the eventual decreased burden of the aforementioned conditions 34,35 .…”

“…However, there is evidence for increased health risks of using formula, which are expected to be compounded in preterm or VLBW infants with an immature gut 3,6,7 . Immediate concerns of formula feeding include an increased risk of feeding intolerance and an association with necrotising enterocolitis (NEC) and late‐onset sepsis, all of which hinder growth and development 3,6,8 .…”

“…However, there is evidence for increased health risks of using formula, which are expected to be compounded in preterm or VLBW infants with an immature gut 3,6,7 . Immediate concerns of formula feeding include an increased risk of feeding intolerance and an association with necrotising enterocolitis (NEC) and late‐onset sepsis, all of which hinder growth and development 3,6,8 . Individual studies and systematic reviews have also shown possible association between formula feeding and an increased risk of later life conditions such as atopy, 2,7 diabetes 2,7,9,10 and childhood obesity 2,7,9–11 .…”

“…Furthermore, BM has been shown to enhance gastrointestinal growth and maturation, increase gastric emptying and intestinal motility and increase tolerance of a full enteral feeding for preterm and VLBW infants, 3,14,16 possibly owing to the macronutrients in BM being more easily digested than formula 17 . Various neurodevelopmental advantages have also been associated with BM when compared with infants fed with formula, including superior mental and motor development, visual acuity and intelligence quotient 3,16 .…”

“…Furthermore, BM has been shown to enhance gastrointestinal growth and maturation, increase gastric emptying and intestinal motility and increase tolerance of a full enteral feeding for preterm and VLBW infants, 3,14,16 possibly owing to the macronutrients in BM being more easily digested than formula 17 . Various neurodevelopmental advantages have also been associated with BM when compared with infants fed with formula, including superior mental and motor development, visual acuity and intelligence quotient 3,16 . A major benefit of BM is the delivery of immunoprotective and growth factors 4 to the immature gut mucosa against NEC, 12,13,15 late onset sepsis, 12 diarrhoea 13 and urinary and upper respiratory tract infections, 13 which are all causes of premature infant morbidity and mortality 6,14,16 .…”