Pasteurized donor human milk for VLBW infants: The effect on necrotizing enterocolitis and related factors

A Systematic Review and Meta-Analysis of Human Milk Feeding and Morbidity in Very Low Birth Weight Infants

“…The search and selection processes are described in Figure S1 . Forty-nine unique studies (with 56 reports) were identified for this review and included 6 RTs [ 32 , 33 , 34 , 35 , 36 , 37 ], 1 non-randomised intervention trial [ 38 ], 27 cohort (with 32 reports) [ 22 , 23 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ], 7 interrupted time series [ 20 , 21 , 69 , 70 , 71 , 72 , 73 ], and 8 case-control studies (with 10 reports) [ 74 , 75 , 76 , 77 , 78 , …”

“…NEC was reported in 42 studies and severe NEC, defined as NEC requiring surgery, in 12 [ 23 , 32 , 33 , 34 , 37 , 41 , 49 , 63 , 64 , 66 , 70 , 76 ]. NEC was defined by most as Bell’s stage 2 or higher, with 6 defining by clinical signs and or radiological evidence [ 37 , 38 , 55 , 61 , 63 , 65 ] and 8 studies [ 22 , 23 , 40 , 49 , 50 , 54 , 60 , 71 ] providing no definition ( Table 1 ).…”

“…Observational studies: Twenty-two observational studies (16 cohort studies [ 22 , 23 , 41 , 42 , 43 , 47 , 49 , 51 , 54 , 55 , 56 , 60 , 64 , 65 , 66 , 73 ], 5 interrupted time series [ 21 , 69 , 70 , 71 , 72 ], and 1 non-randomised arm of an intervention trial [ 36 ]) were included in the meta-analysis for this comparison ( Table 1 ) which showed a significant reduction in any NEC (RR 0.53, 95% CI 0.42, 0.67, n = 8778; I 2 28%; Figure 1 ; moderate certainty, Table S3 ).…”

TGF-β2, a Protective Intestinal Cytokine, Is Abundant in Maternal Human Milk and Human-Derived Fortifiers but Not in Donor Human Milk

“…9 Donor human milk (DHM) has become increasingly used when MHM is unavailable; the use of DHM has been shown to decrease the use of formula in preterm infants and not affect the use of MHM. 10 In a retrospective single-center study, the use of DHM decreased the incidence of surgical NEC. 10 Contrary to this result, in a randomized trial, DHM used as a supplement to MHM was not superior to preterm formula for the reduction of NEC in preterm infants, but none of the groups had a strict humanderived diet when it has been shown to be beneficial.…”

“…10 In a retrospective single-center study, the use of DHM decreased the incidence of surgical NEC. 10 Contrary to this result, in a randomized trial, DHM used as a supplement to MHM was not superior to preterm formula for the reduction of NEC in preterm infants, but none of the groups had a strict humanderived diet when it has been shown to be beneficial. 9,11 DHM undergoes pasteurization, which decreases bacterial and viral counts, including human immunodeficiency virus and cytomegalovirus, but levels of many of the beneficial immunologic factors decrease as well.…”