Effects of Formula Milk Feeding in Premature Infants: A Systematic Review

Abstract

The preterm baby is born at a critical period for the growth and development of the gastrointestinal and neuromotor systems. Breast milk is the food of choice for infants during the first months of life, as it provides multiple short- and long-term benefits to preterm and sick newborns. Despite this, breastfeeding is often nutritionally insufficient, requiring the addition of fortifiers. In other cases, it is important to ensure the necessary nutrients and calories, which can be provided by formula milk or pasteurized and fortified donated human milk. However, the specific guidelines for the use of formula milk have not yet been determined. Therefore, a systematic search was considered necessary in order to identify the effects of feeding with formula milk in preterm infants. A systematic search in Scopus, Medline, Pubmed, Cinahl, ClinicalTrials and Web of Science with the terms Infant Formula and Infant Premature was conducted. A total of 18 articles were selected, of which, eight were experimental and ten were observational studies. Among the objectives of the analyzed investigations, we distinguished nine that compared the effects of feeding with formula milk, breast milk and donated human milk, five that evaluated the effects of different compositions of formula milk and/or fortifiers and four investigations that compared the effects of formula milk and donated human milk. In conclusion, when breast milk is insufficient or unavailable, formula milk is a good nutritional option, due to its higher caloric density and protein content. Nevertheless, the preterm infant’s diet should incorporate breast milk to reduce the incidence of morbidities such as necrotizing enterocolitis and sepsis (related to hospital handling of fortifiers and formula milk).

Multisensory stimulation and its effect on breast milk volume production in mothers of premature infants

“…Mother's own milk is undoubtedly the ideal and first food to promote the healthy growth and development of newborns, constituting a fundamental pillar at the beginning of their lives ( 1 ). It is rich in essential nutrients such as proteins, fats, carbohydrates, vitamins and minerals that promote the mental and physical development of premature infants ( 2 ). Therefore, the implementation of policies that actively encourage and promote mother's own milk feeding in this context becomes an unavoidable priority for health institutions ( 3 , 4 ).…”

“…One of the most common conditions faced by premature infants is necrotizing enterocolitis ( 2 ), an inflammation of the colon that occurs in response to the premature development of the digestive system. Necrotizing enterocolitis can have serious and, in some cases, life-threatening consequences, underscoring the importance of ensuring adequate nutrition from the first moments of life.…”

“…Furthermore, the lack of availability of mother's own milk, in neonatal intensive care units, due to the fact that mothers often do not produce enough maternal milk ( 8 ), could be considered as a public health problem. Therefore, the unavailability of mother's own milk for immediate feeding of preterm infants, a common situation in many neonatal intensive care units (NICUs), leads health care providers to rely on donor human milk ( 2 , 8 , 9 ). In this case, the limited number of human milk banks aggravates the problem of neonatal care, as these centers could provide an alternative for feeding premature infants ( 10 ).…”

Determinants of infant behavior and growth in breastfed late preterm and early term infants: a secondary data analysis

“…However, formula milk can be associated with higher incidence of morbidities, notably infection, in preterm infants [15]. 2 Specific behaviours of premature infants differ from those of healthy full-term (FT) infants.…”

In Vivo Assessment of Antioxidant Potential of Human Milk Treated by Holder Pasteurization or High Hydrostatic Pressure Processing: A Preliminary Study on Intestinal and Hepatic Markers in Adult Mice

“…Clinical studies have shown that breast milk (as opposed to infant formula) reduces the NEC incidence in premature infants [ 8 ]. In hospitals, mothers of preterm infants are frequently unable to provide breast milk in sufficient amounts.…”