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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?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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?
- Search Plan and Results: VLBW: Mothers' Milk Supplementation with Donor Milk versus Formula (2019)