Preterm Infant (VLBW) Enteral Nutrition

VLBW: Supplementation of Mothers' Milk with Donor Milk vs Formula (2020)

• Intervention
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on mortality?

  • Conclusion

    In very low birth weight (VLBW) infants receiving 58-89% of intake from mothers' milk, supplementing the remainder of intake with human donor milk versus preterm formula for 10-90 days did not affect risk of mortality [RR (95% CI): 1.01 (0.69, 1.49)].

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation with donor milk vs. formula on mortality?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, de Waard M, Christmann V, van Goudoever J, Jansen-van der Weide M, Kooi E, Koper J, Kouwenhoven S, Lafeber H, Mank E, van Toledo L, Vermeulen M, van Vliet I, van Zoeren-Grobben D. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: The early nutrition study randomized clinical trial. JAMA Pediatrics 2016; 170:654-61
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116:400-6
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on nectorizing enterocolitis?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58-89% of intake from mother's own milk (MOM), supplementing the remainder of intake with human donor milk versus preterm formula decreased risk of necrotizing enterocolities [RR (95% CI): 0.45 (0.24, 0.87)].

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on nectorizing enterocolitis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, de Waard M, Christmann V, van Goudoever J, Jansen-van der Weide M, Kooi E, Koper J, Kouwenhoven S, Lafeber H, Mank E, van Toledo L, Vermeulen M, van Vliet I, van Zoeren-Grobben D. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: The early nutrition study randomized clinical trial. JAMA Pediatrics 2016; 170:654-61
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116:400-6
      • Sullivan S, Schanler R, Kim J, Patel A, Trawöger R, Kiechl-Kohlendorfer U, Chan G, Blanco C, Abrams S, Cotten C, Laroia N, Ehrenkranz R, Dudell G, Cristofalo E, Meier P, Lee M, Rechtman D, Lucas A. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. Journal of Pediatrics 2010; 156:562-7.e1
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on retinopathy of prematurity?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58-89% of intake from mothers' milk, supplementing the remainder of intake with human donor milk versus preterm formula for 10-79 days did not affect risk of retinopathy of prematurity [RR (95% CI): 1.03 (0.73, 1.44)].

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on retinopathy of prematurity?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, de Waard M, Christmann V, van Goudoever J, Jansen-van der Weide M, Kooi E, Koper J, Kouwenhoven S, Lafeber H, Mank E, van Toledo L, Vermeulen M, van Vliet I, van Zoeren-Grobben D. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: The early nutrition study randomized clinical trial. JAMA Pediatrics 2016; 170:654-61
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Sullivan S, Schanler R, Kim J, Patel A, Trawöger R, Kiechl-Kohlendorfer U, Chan G, Blanco C, Abrams S, Cotten C, Laroia N, Ehrenkranz R, Dudell G, Cristofalo E, Meier P, Lee M, Rechtman D, Lucas A. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. Journal of Pediatrics 2010; 156:562-7.e1
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth) what is the effect of supplementation of mothers' milk with donor milk versus formula on sepsis?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58-89% of intake from mothers' milk, supplementing the remainder of intake with human donor milk versus preterm formula for 10-79 days did not affect risk of sepsis [RR (95% CI): 1.10 (0.90, 1.33)].

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mother's milk with donor milk vs. formula on sepsis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, de Waard M, Christmann V, van Goudoever J, Jansen-van der Weide M, Kooi E, Koper J, Kouwenhoven S, Lafeber H, Mank E, van Toledo L, Vermeulen M, van Vliet I, van Zoeren-Grobben D. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: The early nutrition study randomized clinical trial. JAMA Pediatrics 2016; 170:654-61
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116:400-6
      • Sullivan S, Schanler R, Kim J, Patel A, Trawöger R, Kiechl-Kohlendorfer U, Chan G, Blanco C, Abrams S, Cotten C, Laroia N, Ehrenkranz R, Dudell G, Cristofalo E, Meier P, Lee M, Rechtman D, Lucas A. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. Journal of Pediatrics 2010; 156:562-7.e1
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on bronchopulmonary disease?

  • Conclusion

    In very low birth weight (VLBW) preterm infants, supplementing mothers' milk with human donor milk vs. preterm formula did not affect risk of bronchopulmonary disease (RR, 1.12; 95% CI, 0.86 to 1.45).

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mother's milk with donor milk vs. formula on bronchopulmonary disease?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, de Waard M, Christmann V, van Goudoever J, Jansen-van der Weide M, Kooi E, Koper J, Kouwenhoven S, Lafeber H, Mank E, van Toledo L, Vermeulen M, van Vliet I, van Zoeren-Grobben D. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: The early nutrition study randomized clinical trial. JAMA Pediatrics 2016; 170:654-61
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on weight gain?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58-82% of intake from mothers' milk, the preponderance of evidence suggests supplementing the remainder of intake with human donor milk vs preterm formula for 60-90 days did not affect weight gain.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mother's milk with donor milk vs. formula on weight gain?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Körnmann, M. N., Christmann, V., Gradussen, C. J., Rodwell, L., Gotthardt, M., Van Goudoever, J. B., & Van Heijst, A. F. . Growth and bone mineralization of very preterm infants at term corrected age in relation to different nutritional intakes in the early postnatal period. Nutrients 2017; 9:1318
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116:400-6
      • Sullivan S, Schanler R, Kim J, Patel A, Trawöger R, Kiechl-Kohlendorfer U, Chan G, Blanco C, Abrams S, Cotten C, Laroia N, Ehrenkranz R, Dudell G, Cristofalo E, Meier P, Lee M, Rechtman D, Lucas A. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. Journal of Pediatrics 2010; 156:562-7.e1
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on length gain?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58-82% of intake from mother's own milk (MOM), supplementing the remainder of intake with human donor milk versus preterm formula for 60-90 days did not affect length gain.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mother's milk with donor milk vs. formula on length gain?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Körnmann, M. N., Christmann, V., Gradussen, C. J., Rodwell, L., Gotthardt, M., Van Goudoever, J. B., & Van Heijst, A. F. . Growth and bone mineralization of very preterm infants at term corrected age in relation to different nutritional intakes in the early postnatal period. Nutrients 2017; 9:1318
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116:400-6
      • Sullivan S, Schanler R, Kim J, Patel A, Trawöger R, Kiechl-Kohlendorfer U, Chan G, Blanco C, Abrams S, Cotten C, Laroia N, Ehrenkranz R, Dudell G, Cristofalo E, Meier P, Lee M, Rechtman D, Lucas A. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. Journal of Pediatrics 2010; 156:562-7.e1
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on head circumference?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58% to 82% of intake from mothers' milk, supplementing the remainder of intake with human donor milk vs. preterm formula for 60 to 90 days did not affect head circumference gain.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on head circumference?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
      • Schanler R, Lau C, Hurst N, Smith E. Randomized trial of donor human milk versus preterm formula as substitutes for mothers' own milk in the feeding of extremely premature infants. Pediatrics 2005; 116:400-6
      • Sullivan S, Schanler R, Kim J, Patel A, Trawöger R, Kiechl-Kohlendorfer U, Chan G, Blanco C, Abrams S, Cotten C, Laroia N, Ehrenkranz R, Dudell G, Cristofalo E, Meier P, Lee M, Rechtman D, Lucas A. An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. Journal of Pediatrics 2010; 156:562-7.e1
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on body composition?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving mothers' milk, supplementing the remainder of intake with human donor milk vs. preterm formula did not result in differences in lean body mass or fat mass at term-corrected age.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on body composition?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Körnmann, M. N., Christmann, V., Gradussen, C. J., Rodwell, L., Gotthardt, M., Van Goudoever, J. B., & Van Heijst, A. F. . Growth and bone mineralization of very preterm infants at term corrected age in relation to different nutritional intakes in the early postnatal period. Nutrients 2017; 9:1318
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on neurodevelopment?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving 58% to 63% of intake from mothers' milk, supplementing the remainder of intake with human donor milk vs. preterm formula for 60 to 65 days did not affect Bayley Development scores after 18 months, but did result in a higher risk difference of cognitive neuroimpairment.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on development?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • O'Connor D, Gibbins S, Kiss A, Bando N, Brennan-Donnan J, Ng E, Campbell D, Vaz S, Fusch C, Asztalos E, Church P, Kelly E, Ly L, Daneman A, Unger S. Effect of supplemental donor human milk compared with preterm formula on neurodevelopment of very low-birth-weight infants at 18 months: a randomized clinical trial. JAMA 2016; 316:1897-1905
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on gastrointestinal health?

  • Conclusion

    For infants receiving mothers' milk, when the remainder or intake was supplemented with human milk products (donor milk and human-based fortifier) compared to bovine products (preterm formula and bovine fortifier) for 74 to 79 days, there was a reduced hazard of parenteral nutrition. However, no effect was seen with shorter duration and bovine-based fortifiers in both groups.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on gastrointestinal health?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Corpeleijn W, de Waard M, Christmann V, van Goudoever J, Jansen-van der Weide M, Kooi E, Koper J, Kouwenhoven S, Lafeber H, Mank E, van Toledo L, Vermeulen M, van Vliet I, van Zoeren-Grobben D. Effect of donor milk on severe infections and mortality in very low-birth-weight infants: The early nutrition study randomized clinical trial. JAMA Pediatrics 2016; 170:654-61
      • Ghandehari H Lee M, Rechtman D. An exclusive human milk-based diet in extremely premature infants reduces the probability of remaining on total parenteral nutrition: a reanalysis of the data. BMC Research Notes 2012; 5:188
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)
     
  In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on bone mineral content?

  • Conclusion

    In very low birth weight (VLBW) preterm infants receiving mothers' milk, supplementing the remainder of intake with human donor milk vs. preterm formula did not result in differences in bone content, density or area at term-corrected age.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In VLBW preterm infants (less than or equal to 1,500g at birth), what is the effect of supplementation of mothers' milk with donor milk vs. formula on bone mineral content?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Körnmann, M. N., Christmann, V., Gradussen, C. J., Rodwell, L., Gotthardt, M., Van Goudoever, J. B., & Van Heijst, A. F. . Growth and bone mineralization of very preterm infants at term corrected age in relation to different nutritional intakes in the early postnatal period. Nutrients 2017; 9:1318
  • Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)